Organization
PARK ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAROUKH LEVI MD (PRESIDENT)
(219) 934-5300
Entity
Organization
Contact information
Practice address
151 DUNDEE AVE, EAST DUNDEE, IL 60118-1648
(847) 551-9601
Mailing address
541 OTIS BOWEN DR, MUNSTER, IN 46321-4158
(219) 934-5300
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633948
IL BCBS
IL
Enumeration date
01/25/2008
Last updated
01/25/2008
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