Organization
ANESTHESIA PAIN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE FANCHER MD (PRESIDENT)
(217) 464-5839
Entity
Organization
Contact information
Practice address
111 SPRING ST, STREATOR, IL 61364-3332
(815) 673-2311
(847) 615-2858
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(217) 464-5839
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
04/14/2011
Last updated
04/15/2011
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