Midwest Mobile Anesthesia Consultants, SC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

042620313 Issued in IL

Legal business name

MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC

Practice address

210 W Walnut St
Canton, IL 61520-2444

Phone

(309) 692-6572

NPI assigned

Feb 5, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Adrienne Yvette Williams, M.D.

Title

President

Phone

(309) 453-1379

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1790143683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 W STONEWATER DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616158852",
            "telephone_number": "309-692-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W WALNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202444",
            "telephone_number": "309-692-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-453-1379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "042620313",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "042620313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Presley Kayln McConkey, PTA
• Lacey N McMahill, APN
• Philip James Mead, MD
• Elise Marie Mefford, FNP
• Amanda Meyers Broughton, PTA
• Brittany Nicole Miller, APRN FNP-C
• Melanie A Miller, APN
• Meredith Kay Milleson
• Miriam S Mindeman, M.A., L.P.C.
• Brad Adam Moltrup, P.T. M.S.

• Anesthesiology Physician in Canton, IL
• Providers in Canton, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.