Airway Anesthesia PC
Anesthesiology in Normal, IL. Organization (NPI-2).
NPI number1992064166
StatusActive
Last updated in NPPESApr 30, 2015
Details
- NPI
- 1992064166
- Entity type
- Organization (NPI-2)
- Legal business name
- Airway Anesthesia PC
- Organization subpart
- No
- Enumeration date
- May 9, 2012
- Last updated
- Apr 30, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | 209-001108 | IL | Yes |
Practice location
1105 Sterling Glen Cc CtNormal, IL 61761-5297
Phone 309-454-4617 · Fax 877-757-6325
Mailing address
1105 Sterling Glen Cc CtNormal, IL 61761-5297
Phone 309-454-4617 · Fax 877-757-6325
Authorized official
Daryl D Chenoweth
Director
3094544617
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