Basic Information
| Provider Information | |||||||||
| NPI: | 1811940877 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHNSON COUNTY ANESTHESIOLOGISTS, CHARTERED | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 75443 | ||||||||
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| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606755443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172635562 | ||||||||
| FaxNumber: | 7172631566 | ||||||||
| Practice Location | |||||||||
| Address1: | 20375 W 151ST ST | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660615306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137822292 | ||||||||
| FaxNumber: | 9137822381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 09/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | MUNRO | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9136858861 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.