Provider Demographics
NPI:1295156602
Name:WEST CENTRAL ANESTHESIOLOGY GROUP LTD.
Entity type:Organization
Organization Name:WEST CENTRAL ANESTHESIOLOGY GROUP LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-756-5760
Mailing Address - Street 1:9550 W HIGGINS RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4962
Mailing Address - Country:US
Mailing Address - Phone:773-756-5760
Mailing Address - Fax:
Practice Address - Street 1:9550 W HIGGINS RD STE 1100
Practice Address - Street 2:
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-4962
Practice Address - Country:US
Practice Address - Phone:773-756-5760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-044476207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC44163Medicare UPIN