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NPI Code Detail

MEDICARE: MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC

MEDICARE: MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1417515024
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC
Provider Business Mailing Address
First Line : 9680 GOLF RD
Second Line :
City : DES PLAINES
State : IL
Zip : 60016-1522
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9615 KEILMAN ST
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-9406
Country : US
Telephone Number : 773-362-2914
Fax Number :
Authorized Official
Title or Position : PRACTICE MANAGER
Name : GABRIELA MALDONADO
Credential :
Telephone Number : 773-362-2917
Provider Enumeration Date : 05/30/2019
Last Update Date : 04/07/2025

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Directions to “MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC ” Practice Location

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