Organization
IHC-WHEATON ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN VAUGHN (VP)
(973) 251-1132
Entity
Organization
Contact information
Practice address
10148 S 27TH ST, OAK CREEK, WI 53154-5528
(417) 889-2040
Mailing address
PO BOX 744492, ATLANTA, GA 30374-4492
(973) 251-1132
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
02/11/2021
Last updated
05/19/2023
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