Provider Demographics
NPI:1669653580
Name:METRO ANESTHESIA CONSULTANTS LLC
Entity Type:Organization
Organization Name:METRO ANESTHESIA CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:NANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-540-0130
Mailing Address - Street 1:195 N HARBOR DR
Mailing Address - Street 2:SUITE 3302
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7514
Mailing Address - Country:US
Mailing Address - Phone:312-540-0130
Mailing Address - Fax:
Practice Address - Street 1:195 N HARBOR DR
Practice Address - Street 2:SUITE 3302
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7514
Practice Address - Country:US
Practice Address - Phone:312-540-0130
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