Provider Demographics
NPI:1124079371
Name:ORION ANESTHESIA ASSOCIATES, PC
Entity type:Organization
Organization Name:ORION ANESTHESIA ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MIGON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:847-891-2630
Mailing Address - Street 1:333 BUSSE HWY
Mailing Address - Street 2:#991
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-0991
Mailing Address - Country:US
Mailing Address - Phone:847-891-2630
Mailing Address - Fax:847-278-5406
Practice Address - Street 1:60 S. DEE RD.
Practice Address - Street 2:SUITE F
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-0991
Practice Address - Country:US
Practice Address - Phone:847-891-2630
Practice Address - Fax:847-278-5406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL62480858367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203229Medicare ID - Type Unspecified