Provider Demographics
NPI:1821733726
Name:GIP ANESTHESIA SERVICES PLLC
Entity Type:Organization
Organization Name:GIP ANESTHESIA SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-401-0868
Mailing Address - Street 1:1880 W WINCHESTER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5321
Mailing Address - Country:US
Mailing Address - Phone:815-401-0868
Mailing Address - Fax:
Practice Address - Street 1:22285 N PEPPER RD STE 312
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2541
Practice Address - Country:US
Practice Address - Phone:847-382-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty