# AEGIS AMBULATORY ANESTHESIA, LTD

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

## Provider details

- **NPI number:** 1104198647
- **Authorized official:** MS. ALICIA CITARI CRNA (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (630) 640-9618

## Contact information

- **Practice address:** 6701 WEST 159TH STREET, TINLEY PARK, IL 60477-1758
- **Practice address phone:** (708) 429-0222
- **Mailing address:** 5740 WASHINGTON ST, DOWNERS GROVE, IL 60516-1311
- **Mailing address phone:** (630) 640-9618

## 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 | — | — | — |
| 367H00000X | Anesthesiologist Assistant | — | NULL | — |
| 367H00000X | Anesthesiologist Assistant | — | — | — |

## Other

- **Enumeration date:** 01/30/2012
- **Last updated:** 11/22/2016