Premiercare Anesthesia & Pain P.C.
Anesthesiology in Chicago, IL. Organization (NPI-2).
NPI number1649696147
StatusActive
Last updated in NPPESJan 13, 2016
Details
- NPI
- 1649696147
- Entity type
- Organization (NPI-2)
- Legal business name
- Premiercare Anesthesia & Pain P.C.
- Organization subpart
- No
- Enumeration date
- Mar 9, 2014
- Last updated
- Jan 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | 036.087570 | IL | Yes |
| 207LP2900X | Anesthesiology, Pain Medicine | 036.087570 | IL |
Practice location
3407 W Fullerton AveChicago, IL 60647-2497
Phone 312-475-1203 · Fax 312-929-3739
Mailing address
200 W Menomonee StUnit 4
Chicago, IL 60614-5313
Phone 630-400-4881 · Fax 312-929-3739
Authorized official
Daniel Maksimovich
President
6304004881
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