Organization
CJB ANESTHESIA SERVICES INC
Active
Organization
CJB ANESTHESIA SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL J BERGBOWER CRNA (PRESIDENT)
(618) 546-2410
Entity
Organization
Contact information
Practice address
1000 N ALLEN ST, ROBINSON, IL 62454-1167
(618) 544-3131
Mailing address
7797 E 1050TH AVE, ROBINSON, IL 62454-4734
(618) 544-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01732004
BLUE CROSS BLUE SHIELD
IL
01
—
020354300
BLACK LUNG
IL
01
—
DA2630
RAILROAD MEDICARE GROUP #
IL
Enumeration date
06/05/2006
Last updated
05/12/2010
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