# CRAWFORD AVENUE ANESTHESIA PROVIDER SERVICES URBANA, LLC

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

## Provider details

- **NPI number:** 1134566615
- **Authorized official:** RONALD HAYES M.D. (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (708) 326-1630

## Contact information

- **Practice address:** 1400 W PARK ST, URBANA, IL 61801-2334
- **Practice address phone:** (217) 337-2000
- **Mailing address:** PO BOX 1278, BEDFORD PARK, IL 60499-1278
- **Mailing address phone:** (217) 337-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2013
- **Last updated:** 06/19/2013