# COLLINS AMBULATORY ANESTHESIA SERVICES SC

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

## Provider details

- **NPI number:** 1992003636
- **Authorized official:** DR. GREGORY COLLINS M.D. (PRESIDENT)
- **Authorized official phone:** (618) 973-5189

## Contact information

- **Practice address:** 106 FRIARS LN, EDWARDSVILLE, IL 62025-3876
- **Practice address phone:** (618) 973-5189
- **Mailing address:** 106 FRIARS LN, EDWARDSVILLE, IL 62025-3876
- **Mailing address phone:** (618) 973-5189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 036079652 | IL | Yes |

## Other

- **Enumeration date:** 03/04/2011
- **Last updated:** 03/04/2011