NPIMap

Organization Active NPI

Anesthesia Specialties Alliance, S.C.

  • Anesthesiology Physician
  • Peoria, IL
National Provider Identifier
1245208685
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
042617566 Issued in IL
Legal business name
ANESTHESIA SPECIALTIES ALLIANCE, S.C.
Practice address
7309 N. Knoxville Ave.
Peoria, IL 61614
Phone
(309) 360-2600
Fax
(309) 683-1003
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Authorized official

Name
Mr. Keith Harvey Ifft, M.D.
Title
Vice-President
Phone
(309) 360-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 042617566 IL Primary

Addresses

Primary practice location

7309 N. Knoxville Ave.
Peoria, IL 61614

Mailing address

7309 N. Knoxville Ave
Peoria, IL 61614
Phone (309) 360-2600

National Provider Directory

National Provider Directory

Locations

2502 E Empire St
Ste B
Bloomington, IL 61704
Phone (309) 662-6120

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1245208685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 N. KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-360-2600",
            "fax_number": "309-683-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N. KNOXVILLE AVE.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-360-2600",
            "fax_number": "309-683-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA SPECIALTIES ALLIANCE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "IFFT",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "309-360-2600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "042617566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.