Provider Demographics
NPI:1629082326
Name:VALLEY AMBULATORY SURGERY CENTER ANESTHESIOLOGY LTD
Entity Type:Organization
Organization Name:VALLEY AMBULATORY SURGERY CENTER ANESTHESIOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GIAMBERDINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-584-9800
Mailing Address - Street 1:2475 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4831
Mailing Address - Country:US
Mailing Address - Phone:630-584-9800
Mailing Address - Fax:
Practice Address - Street 1:2475 DEAN ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4831
Practice Address - Country:US
Practice Address - Phone:630-584-9800
Practice Address - Fax:630-584-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL777380Medicare ID - Type Unspecified