Provider Demographics
NPI:1447581541
Name:SW ANESTHESIOLOGY LIMITED
Entity Type:Organization
Organization Name:SW ANESTHESIOLOGY LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:WAHOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-887-1201
Mailing Address - Street 1:104 CIRCLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-8379
Mailing Address - Country:US
Mailing Address - Phone:630-632-4435
Mailing Address - Fax:773-767-8133
Practice Address - Street 1:104 CIRCLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-8379
Practice Address - Country:US
Practice Address - Phone:630-632-4435
Practice Address - Fax:773-767-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036072981174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036072981Medicaid
IL1982708582OtherPERSONAL NPI