# PRAIRIE ANESTHESIA LLC

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

## Provider details

- **NPI number:** 1225115934
- **Authorized official:** MILORAD CUPIC (PRESIDENT)
- **Authorized official phone:** (312) 567-2000

## Contact information

- **Practice address:** 2525 S MICHIGAN AVE, CHICAGO, IL 60616-2333
- **Practice address phone:** (312) 567-2000
- **Mailing address:** PO BOX 4602, DEPT 4041, OAK BROOK, IL 60522-4602

## 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:** 11/01/2006
- **Last updated:** 10/29/2007