Organization
ANESTHESIA ASSOCIATES OF STREATOR SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALVIN SLOT (PRESIDENT)
(815) 673-2311
Entity
Organization
Contact information
Practice address
111 SPRING ST, STREATOR, IL 61364-3332
(815) 673-2311
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05032038
BCBS
IL
Enumeration date
08/15/2006
Last updated
10/29/2007
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