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Organization

PRINCIPLE ANESTHESIA PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL KEEDY CRNA (OWNER)
(309) 267-5510
Entity
Organization

Contact information

Practice address
430 MAXINE DR, MORTON, IL 61550-2495
(309) 495-4520
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(847) 615-2858

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Enumeration date
01/24/2023
Last updated
01/26/2023
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