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NPI Code Detail

MEDICARE: ALLIANCE ANESTHESIOLOGISTS, S.C.

MEDICARE: ALLIANCE ANESTHESIOLOGISTS, S.C.
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
1207L00000XAnesthesiology Physician
2208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1477502367
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE ANESTHESIOLOGISTS, S.C.
Provider Business Mailing Address
First Line : 185 PENNY AVE
Second Line :
City : EAST DUNDEE
State : IL
Zip : 60118-1454
Country : US
Telephone Number : 847-836-7015
Fax Number :
Provider Business Practice Location Address
First Line : 7200 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60645-1812
Country : US
Telephone Number : 773-743-6700
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : MR. KENDALL R. LUTZ
Credential :
Telephone Number : 847-836-7015
Provider Enumeration Date : 05/08/2006
Last Update Date : 09/11/2025

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