Organization
IROQUOIS ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KASHYAP S BHATT MD (PRESIDENT/OWNER)
(815) 432-5747
Entity
Organization
Contact information
Practice address
514 S 5TH ST, WATSEKA, IL 60970-1637
(815) 432-5747
(815) 432-5747
Mailing address
514 S 5TH ST, WATSEKA, IL 60970-1637
(815) 432-5747
(815) 432-5747
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036067666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067666
—
IL
01
—
03815089
BLUE CROSS BLUE SHIELD
IL
01
—
050026030
RAIL ROAD MEDICARE
—
05
—
100031610A
—
IN
Enumeration date
05/22/2008
Last updated
06/05/2008
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