Provider Demographics
NPI:1245714724
Name:THE ANESTHESIA COLLECTIVE INC
Entity type:Organization
Organization Name:THE ANESTHESIA COLLECTIVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAJJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-757-4647
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-0070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:820 W JACKSON BLVD STE 310
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3062
Practice Address - Country:US
Practice Address - Phone:312-757-4647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty