Organization
PREMIER ANESTHESIA OF DANVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA SOBOL (OPERATIONS MANAGER)
(217) 443-5000
Entity
Organization
Contact information
Practice address
812 N LOGAN AVE, DANVILLE, IL 61832-3752
(217) 443-5000
Mailing address
PO BOX 532904, ATLANTA, GA 30353-2904
(217) 443-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09232012
BCBS OF IL
AZ
01
—
DA4244
RAILROAD MEDICARE
AZ
Enumeration date
11/22/2006
Last updated
04/02/2008
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