Provider Demographics
NPI:1104208164
Name:ANTHONY, JOSEPH (CRNA)
Entity Type:Individual
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First Name:JOSEPH
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:836 W WELLINGTON AVE STE 4815
Mailing Address - Street 2:CHICAGO ANESTHESIA ASSOCIATES/ AIMMC
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5147
Mailing Address - Country:US
Mailing Address - Phone:773-296-7041
Mailing Address - Fax:773-296-5088
Practice Address - Street 1:836 W WELLINGTON AVE STE 4815
Practice Address - Street 2:CHICAGO ANESTHESIA ASSOCIATES/ AIMMC
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5147
Practice Address - Country:US
Practice Address - Phone:773-296-7041
Practice Address - Fax:773-296-5088
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2023-09-07
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Provider Licenses
StateLicense IDTaxonomies
IL209012844367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered