Organization
PREMIUM ANESTHESIA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARI JORDAN CRNA (NURSE ANESTHESIST)
(630) 862-9756
Entity
Organization
Contact information
Practice address
700 PASQUINELLI DR, WESTMONT, IL 60559-1382
(630) 323-8690
Mailing address
PO BOX 661495, BIRMINGHAM, AL 35266-1495
(205) 979-5882
(205) 979-1248
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
03/24/2022
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