Organization
PRAIRIE STATE ANESTHESIA ASSOCIATES, PLLC
Active
Organization
PRAIRIE STATE ANESTHESIA ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE SMITH (ENROLLMENT)
(425) 803-3885
Entity
Organization
Contact information
Practice address
5023 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-3453
(618) 239-0678
Mailing address
3414 PEACHTREE RD NE STE 340, ATLANTA, GA 30326-1137
(425) 803-3885
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
07/23/2025
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