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NPI Code Detail

MEDICARE: GLEN OAKS ANESTHESIOLOGISTS, SC

MEDICARE: GLEN OAKS ANESTHESIOLOGISTS, 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
1174400000XSpecialist

General Provider Information

NPI Number : 1992740583
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLEN OAKS ANESTHESIOLOGISTS, SC
Provider Business Mailing Address
First Line : 744 W MICHIGAN AVE
Second Line :
City : JACKSON
State : MI
Zip : 49201-1909
Country : US
Telephone Number : 517-787-6440
Fax Number : 517-787-4146
Provider Business Practice Location Address
First Line : 701 WINTHROP AVE
Second Line :
City : GLENDALE HEIGHTS
State : IL
Zip : 60139-1405
Country : US
Telephone Number : 630-545-5980
Fax Number :
Authorized Official
Title or Position : AUTHORISED REPRESENTATIVE
Name : DR. ABDEL ANWAR
Credential : M.D
Telephone Number : 630-545-5980
Provider Enumeration Date : 06/18/2006
Last Update Date : 08/22/2020

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Directions to “GLEN OAKS ANESTHESIOLOGISTS, SC ” Practice Location

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