Organization
ILLINOIS ANESTHESIA ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL MD (PRESIDENT)
(800) 444-6110
Entity
Organization
Contact information
Practice address
350 N WALL ST, KANKAKEE, IL 60901-2901
(815) 933-1671
Mailing address
PO BOX 550374, TAMPA, FL 33655-0374
(847) 615-2200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4632035
BCBS
IL
Enumeration date
05/28/2006
Last updated
10/29/2007
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