Organization
LIBERTY ANESTHESIA & PAIN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD I HUSSAIN MD (OWNER)
(847) 409-0410
Entity
Organization
Contact information
Practice address
1634 AVENUE OF THE CITIES, MOLINE, IL 61265-4860
(309) 762-9711
(309) 762-9747
Mailing address
5530 RIVER PARK DR, LIBERTYVILLE, IL 60048-4204
(847) 281-7235
(847) 409-0410
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036083169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036083169
LICENSE
IL
01
—
36845020
LICENSE
WI
Enumeration date
02/18/2014
Last updated
02/18/2014
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