Provider Demographics
NPI:1508047390
Name:SUPERIOR ANESTHESIA LLC
Entity Type:Organization
Organization Name:SUPERIOR ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHECHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-444-6110
Mailing Address - Street 1:1770 1ST ST
Mailing Address - Street 2:SUITE 703
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3200
Mailing Address - Country:US
Mailing Address - Phone:847-433-1539
Mailing Address - Fax:
Practice Address - Street 1:701 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4037
Practice Address - Country:US
Practice Address - Phone:219-924-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty