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Organization

EPIX ANESTHESIA OF CENTRAL ILLINOIS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH PRUITT M.D. (OWNER)
(678) 580-1349
Entity
Organization

Contact information

Practice address
12935 GREGORY ST, BLUE ISLAND, IL 60406-2428
(678) 580-1349
(770) 559-1231
Mailing address
1080 HOLCOMB BRIDGE RD STE 330, ROSWELL, GA 30076-4346
(678) 580-1349
(770) 559-1231

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Enumeration date
10/07/2013
Last updated
06/24/2020
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