Organization
PREMIER ANESTHESIA OF ILLINOIS PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WALKER (VP)
(678) 690-7812
Entity
Organization
Contact information
Practice address
375 N WALL ST, KANKAKEE, IL 60901-3483
(855) 369-7546
Mailing address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207LP3000X
Pediatric Anesthesiology Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us