# RESOLUTE ANESTHESIA ILLINOIS SC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1245661560
- **Authorized official:** KAREN VAUGHN (OFFICER)
- **Authorized official phone:** (954) 838-2371

## Contact information

- **Practice address:** 501 HAMACHER ST, WATERLOO, IL 62298-1568
- **Practice address phone:** (908) 653-9399
- **Practice address fax:** (908) 653-9305
- **Mailing address:** PO BOX 744130, ATLANTA, GA 30374-4130
- **Mailing address phone:** (908) 653-9399
- **Mailing address fax:** (908) 653-9305

## 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:** 12/12/2013
- **Last updated:** 05/05/2023