Organization
ATP ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WAT M.D. (CHAIRMAN)
(630) 859-2222
Entity
Organization
Contact information
Practice address
1325 N HIGHLAND AVE, PROVENA MERCY MEDICAL CENTER, AURORA, IL 60506-1449
(630) 859-2222
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(630) 874-2542
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
07/15/2006
Last updated
07/16/2007
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