Organization
CORE ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA LACEK CRNA (OWNER)
(800) 444-6110
Entity
Organization
Contact information
Practice address
10400 SOUTHWEST HWY, CHICAGO RIDGE, IL 60415-1367
(708) 581-7308
(708) 851-7309
Mailing address
PO BOX 70, LAKE FOREST, IL 60045-0070
(847) 457-3800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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