Organization
PREMIERE ANESTHESIA GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERTRAND D CHAUFF CRNA (OWNER)
(847) 208-0353
Entity
Organization
Contact information
Practice address
605 S LINCOLN AVE, PARK RIDGE, IL 60068-4506
(847) 208-0353
Mailing address
5127 HIGHWAY 17, MURRELLS INLET, SC 29576-5045
(843) 651-2624
(843) 491-4023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209010019
IL
Other
Enumeration date
05/28/2015
Last updated
05/29/2015
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