Provider Demographics
NPI:1154714731
Name:MIDWEST ANESTHESIA AND PAIN SPECIALISTS SC
Entity type:Organization
Organization Name:MIDWEST ANESTHESIA AND PAIN SPECIALISTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALDANHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-362-2917
Mailing Address - Street 1:2005 W. 75TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-2308
Mailing Address - Country:US
Mailing Address - Phone:630-985-4700
Mailing Address - Fax:630-985-4523
Practice Address - Street 1:2007 75TH ST
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2308
Practice Address - Country:US
Practice Address - Phone:630-985-4700
Practice Address - Fax:630-985-4523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF10049755Medicare PIN