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Organization
ANESTHESIA ASSOCIATES OF SOUTHERN ILLINOIS SURGERY CENTER LLC
Active
Organization
ANESTHESIA ASSOCIATES OF SOUTHERN ILLINOIS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KLOPFENSTEIN (FINANCIAL OPERATIONS MANAGER)
(314) 368-5849
Entity
Organization
Contact information
Practice address
2 GOOD SAMARITAN WAY STE 200, MOUNT VERNON, IL 62864-2476
(618) 899-5703
(618) 899-5704
Mailing address
2 GOOD SAMARITAN WAY, SUITE 205, MOUNT VERNON, IL 62864-2408
(618) 899-3869
(618) 899-3558
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/24/2017
Last updated
03/08/2017
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