Provider Demographics
NPI:1558432575
Name:PAINLESS ANESTHESIA PROVIDERS S. C.
Entity Type:Organization
Organization Name:PAINLESS ANESTHESIA PROVIDERS S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COLLECTION
Authorized Official - Prefix:MS
Authorized Official - First Name:GERDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KULKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-637-1700
Mailing Address - Street 1:2333 N HARLEM AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-2718
Mailing Address - Country:US
Mailing Address - Phone:773-637-1700
Mailing Address - Fax:773-637-2881
Practice Address - Street 1:2333 N HARLEM AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-2718
Practice Address - Country:US
Practice Address - Phone:773-637-1700
Practice Address - Fax:773-637-2881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01636192OtherBLUE SHIELD PROVIDER NUMB