Provider Demographics
NPI:1639056047
Name:GI ANESTHESIA PROVIDERS OF ILLINOIS, PLLC
Entity type:Organization
Organization Name:GI ANESTHESIA PROVIDERS OF ILLINOIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-407-4789
Mailing Address - Street 1:950 TECHNOLOGY WAY STE 130&250
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5366
Mailing Address - Country:US
Mailing Address - Phone:224-407-4400
Mailing Address - Fax:224-407-2255
Practice Address - Street 1:950 TECHNOLOGY WAY STE 130&250
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5366
Practice Address - Country:US
Practice Address - Phone:224-407-4400
Practice Address - Fax:224-407-2255
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE GASTROINTESTINAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty