Southern Illinois Anesthesiology Ltd
Anesthesiology, Pain Medicine in Mount Vernon, IL. Organization (NPI-2).
NPI number1346353661
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1346353661
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Illinois Anesthesiology Ltd
- Organization subpart
- No
- Enumeration date
- Aug 17, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP2900X | Anesthesiology, Pain Medicine | 42617784 | IL | Yes |
| 207L00000X | Anesthesiology | 42617784 | IL | |
| 367500000X | Nurse Anesthetist, Certified Registered | 42617784 | IL |
Practice location
605 N 12th StreetMount Vernon, IL 62864-2857
Phone 618-241-1108 · Fax 618-241-3805
Mailing address
4227 Lincolnshire DriveMount Vernon, IL 62864-2157
Phone 618-242-2317 · Fax 618-242-9710
Authorized official
Frank M Eaton
President
6182411108
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