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Organization
BUREAU VALLEY ANESTHESIA GROUP, INC.
Active
Organization
BUREAU VALLEY ANESTHESIA GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEOFIL L ORTEZA MD (OWNER)
(815) 875-6001
Entity
Organization
Contact information
Practice address
130 N MAIN ST, PRINCETON, IL 61356-1785
(815) 875-6001
(815) 875-3612
Mailing address
130 N MAIN ST, PO BOX 372, PRINCETON, IL 61356-1785
(815) 875-6001
(815) 875-3612
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036054242
IL
Other
Enumeration date
12/01/2006
Last updated
06/24/2014
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