Basic Information
| Provider Information | |||||||||
| NPI: | 1134353030 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACUITY ANESTHESIOLOGY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5406 | ||||||||
| Address2: | 5406 RELIABLE PARKWAY | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606805406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145484739 | ||||||||
| FaxNumber: | 8014322668 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 US HIGHWAY 61 | ||||||||
| Address2: | |||||||||
| City: | FESTUS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630284100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145484739 | ||||||||
| FaxNumber: | 8014322668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2009 | ||||||||
| LastUpdateDate: | 01/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | LAPPAS | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6369331033 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | LC0961725 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.