LAKESIDE ANESTHESIOLOGY S.C NPI 1477897023

NPI Information

LAKESIDE ANESTHESIOLOGY, S.C is a non pharmacy dispensing site in Rockford, IL. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) LAKESIDE ANESTHESIOLOGY, S.C NPI is 1477897023. The provider is registered as an organization entity type.
The provider Is Doing Business As 1body4life.

The provider's business location address is:

761 HIGHGROVE PL
ROCKFORD, IL
ZIP 61108-520
Phone: (815) 209-2525

The provider's authorized official is David S. Footerman .
The authorized official title is President and has the following contact phone number (815) 209-2525.

The enumeration date for this NPI number is 11/20/2012 and was last updated on 11/20/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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