NPIMap

Organization Active NPI

Aesthetic Anesthesia, LLC

  • Ambulatory Surgical Clinic/Center
  • Glenview, IL
National Provider Identifier
1023207909
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
041274227 Issued in IL
Legal business name
AESTHETIC ANESTHESIA, LLC
Practice address
1912 Palmgren Dr
Glenview, IL 60025-4216
Phone
(847) 269-9086
NPI assigned
Oct 17, 2007
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kara G. Clark, CRNANPI 1326073487
Title
Owner
Phone
(847) 269-9086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 041274227 IL Primary

Addresses

Primary practice location

1912 Palmgren Dr
Glenview, IL 60025-4216

Mailing address

1912 Palmgren Dr
Glenview, IL 60025-4216
Phone (847) 269-9086

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1023207909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 PALMGREN DR",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254216",
            "telephone_number": "847-269-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 PALMGREN DR",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254216",
            "telephone_number": "847-269-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-269-9086",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "041274227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.