# MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC

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

## Provider details

- **NPI number:** 1790143683
- **Authorized official:** DR. ADRIENNE YVETTE WILLIAMS M.D. (PRESIDENT)
- **Authorized official phone:** (309) 453-1379

## Contact information

- **Practice address:** 210 W WALNUT ST, CANTON, IL 61520-2444
- **Practice address phone:** (309) 692-6572
- **Mailing address:** 4128 W STONEWATER DR, PEORIA, IL 61615-8852
- **Mailing address phone:** (309) 692-6572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 042620313 | IL | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | 042620313 | IL | — |

## Other

- **Enumeration date:** 02/05/2016
- **Last updated:** 02/05/2016