Organization
AAOC SURGERY CENTER ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY F KIOKEMEISTER D.O., MPH (PRESIDENT)
(312) 676-0828
Entity
Organization
Contact information
Practice address
25 E WASHINGTON ST STE 300, CHICAGO, IL 60602-1733
(312) 726-3329
Mailing address
409 WEST HURON ST, SUITE 301, CHICAGO, IL 60654-0001
(312) 676-0828
(312) 944-5801
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036086579
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639014
BLUE SHIELD OF ILLINOIS
IL
Enumeration date
02/22/2008
Last updated
11/24/2009
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