Provider Demographics
NPI:1023612082
Name:ASSOCIATED ANESTHESIOLOGISTS, SC
Entity type:Organization
Organization Name:ASSOCIATED ANESTHESIOLOGISTS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGISTS
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-692-5393
Mailing Address - Street 1:6742 N. FROSTWOD PKWY
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-2402
Mailing Address - Country:US
Mailing Address - Phone:309-692-5393
Mailing Address - Fax:309-683-9998
Practice Address - Street 1:6742 N FROSTWOOD PKWY
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615
Practice Address - Country:US
Practice Address - Phone:309-692-5393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty