Organization
MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADRIENNE YVETTE WILLIAMS M.D. (PRESIDENT)
(309) 453-1379
Entity
Organization
Contact information
Practice address
210 W WALNUT ST, CANTON, IL 61520-2444
(309) 692-6572
Mailing address
4128 W STONEWATER DR, PEORIA, IL 61615-8852
(309) 692-6572
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
042620313
IL
367500000X
Certified Registered Nurse Anesthetist
042620313
IL
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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