Mobile Office-Based Anesthesia of Western New York PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

MOBILE OFFICE-BASED ANESTHESIA OF WESTERN NEW YORK PLLC

Practice address

8420 W Bryn Mawr Ave
Ste 300
Chicago, IL 60631-3479

Phone

(773) 756-5760

Fax

(773) 714-1229

NPI assigned

Dec 23, 2014

Last updated

Dec 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stefan Lucas, MD

Title

President

Phone

(773) 756-5760

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1457749509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 W BRYN MAWR AVE",
            "address_2": "STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313479",
            "telephone_number": "773-756-5760",
            "fax_number": "773-714-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 W BRYN MAWR AVE",
            "address_2": "STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313479",
            "telephone_number": "773-756-5760",
            "fax_number": "773-714-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE OFFICE-BASED ANESTHESIA OF WESTERN NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-756-5760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Chicago, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.