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General NPI Number Information
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NPI Number | 1952308223
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Entity Type | Organization
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Legal Business Name | ANESTHESIA ASSOCIATES, LTD
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 08/19/2009
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Provider Practice Location Address
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Address Line | 2540 HANFORD LN
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City | AURORA
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State | IL
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Zip | 60502-6969
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Country | US
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Telephone | 815-748-8993
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Fax |
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Provider Business Mailing Address
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Address Line | 350 S NORTHWEST HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-4216
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Country | US
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Telephone | 847-720-7457
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Fax | 847-720-7102
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL COULSON
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Credential | D.O.
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Telephone | 815-748-8993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 999999999
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License Number State | IL
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