Organization
ADVANCED ANESTHESIA LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN ROSENTHAL (DIRECTOR)
(224) 231-4363
Entity
Organization
Contact information
Practice address
2937 W 63RD ST, CHICAGO, IL 60629-2753
(224) 231-4363
(866) 642-1525
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
(224) 231-4363
(866) 642-1525
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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