NPIMap

Organization Active NPI

Pediatric Anesthesia Associates, LTD

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1891721775
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PEDIATRIC ANESTHESIA ASSOCIATES, LTD
Practice address
2300 Childrens Place
Chicago, IL 60614
Phone
(773) 880-4415
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Authorized official

Name
Andrew Roth, M.D
Title
Authorized Representative
Phone
(773) 880-4415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2300 Childrens Place
Chicago, IL 60614

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

National Provider Directory

National Provider Directory

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

75 Remittance Dr
Dept 6187
Chicago, IL 60675

1131 Techny Rd
Northbrook, IL 60062
Phone 3122274100 ext. 74100

0N025 Winfield Rd
Winfield, IL 60190
Phone (630) 832-0050

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1891721775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CHILDRENS PLACE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-880-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ANESTHESIA ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "773-880-4415",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.