Organization
LURIE CHILDRENS PEDIATRIC ANESTHESIA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL WITHERS CPCS (DIR OF CREDENTIALING & ENROLLMENT)
(312) 227-6415
Entity
Organization
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-6415
(312) 227-9409
Mailing address
225 E CHICAGO AVE, BOX 118, CHICAGO, IL 60611-2991
(312) 227-6415
(312) 227-9409
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207LP3000X
Pediatric Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
11/22/2016
Last updated
08/24/2022
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