# ANESTHESIA ASSOCIATES OF SOUTHERN ILLINOIS SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043757487
- **Authorized official:** AMANDA KLOPFENSTEIN (FINANCIAL OPERATIONS MANAGER)
- **Authorized official phone:** (314) 368-5849

## Contact information

- **Practice address:** 2 GOOD SAMARITAN WAY STE 200, MOUNT VERNON, IL 62864-2476
- **Practice address phone:** (618) 899-5703
- **Practice address fax:** (618) 899-5704
- **Mailing address:** 2 GOOD SAMARITAN WAY, SUITE 205, MOUNT VERNON, IL 62864-2408
- **Mailing address phone:** (618) 899-3869
- **Mailing address fax:** (618) 899-3558

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 01/24/2017
- **Last updated:** 03/08/2017