Organization
ASSOCIATED ANESTHESIOLOGISTS OF SPRINGFIELD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH KELLY MD (PRESIDENT)
(217) 788-5495
Entity
Organization
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-5495
(217) 788-5496
Mailing address
PO BOX 17037, URBANA, IL 61803-7037
(800) 897-6169
(800) 897-6170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08415645
BC OF IL GROUP PROVIDER #
IL
Enumeration date
02/01/2006
Last updated
01/27/2014
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