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Organization
ANESTHESIA SERVICES, LLC
Active
Organization
ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE L FANCHER MD (PRESIDENT)
(217) 464-5839
Entity
Organization
Contact information
Practice address
1800 E LAKE SHORE DR, SUITE 2500, DECATUR, IL 62521-3810
(217) 464-5839
(217) 464-1693
Mailing address
1800 E LAKE SHORE DR, SUITE 2500, DECATUR, IL 62521-3810
(217) 464-5839
(217) 464-1693
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
06/04/2008
Last updated
08/08/2008
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