Crawford Avenue Anesthesia Provider Services Urbana, LLC

NPI #1134566615 in Urbana, Illinois

Provider Information

NPI Number: 1134566615
Entity Type: Organization
Organization Name: Crawford Avenue Anesthesia Provider Services Urbana, LLC
Primary Specialty: Anesthesiology
Enumeration Date: May 24, 2013
Last Updated: Jun 19, 2013

Practice Location

Address: 1400 W PARK ST
City: Urbana
State: Illinois
ZIP Code: 61801-2334
Phone: (217) 337-2000

Authorized Official

Name: RONALD HAYES, M.D.
Title: AUTHORIZED OFFICIAL
Phone: (708) 326-1630

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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