Organization
METHODIST MEDICAL CENTER OF ILLINOIS
Active
Other names
Methodist Anesthesia Services
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M. CIRONE (REGIONAL MGR-REIMB/REV RECOGNITION)
(309) 672-4813
Entity
Organization
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5522
Mailing address
5271 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-5522
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/25/2007
Last updated
02/14/2020
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