# AIRWAY ANESTHESIA PC

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

## Provider details

- **NPI number:** 1992064166
- **Authorized official:** DARYL D CHENOWETH CRNA (DIRECTOR)
- **Authorized official phone:** (309) 454-4617

## Contact information

- **Practice address:** 1105 STERLING GLEN CC CT, NORMAL, IL 61761-5297
- **Practice address phone:** (309) 454-4617
- **Practice address fax:** (877) 757-6325
- **Mailing address:** 1105 STERLING GLEN CC CT, NORMAL, IL 61761-5297
- **Mailing address phone:** (309) 454-4617
- **Mailing address fax:** (877) 757-6325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 209-001108 | IL | Yes |

## Other

- **Enumeration date:** 05/09/2012
- **Last updated:** 04/30/2015