MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC (NPI# 1790143683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790143683 |
| Entity Type | Organization |
| Organization Name | MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC |
| Practice Address |
210 W Walnut St Canton IL 61520-2444 |
| Mailing Address |
4128 W Stonewater Dr Peoria IL 61615-8852 |
| Practice Telephone | 3096926572 |
| Mailing Telephone | 3096926572 |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |
| Authorized Official Name | DR. ADRIENNE YVETTE WILLIAMS (PRESIDENT) |
| Authorized Official Telephone | 3094531379 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | 042620313 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207L00000X | Anesthesiology | 042620313 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
210 W WALNUT ST |
| City | CANTON |
| State | IL |
| Zip Code | 61520-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376540559 | Andrew Roudebush | Family Medicine | 210 W Walnut St, Canton, IL 61520-2444 | 2005-07-04 |
| 1063046464 | Dara Marie Wagner | Nurse Practitioner | 210 W Walnut St, Canton, IL 61520-2444 | 2020-02-25 |
| 1235699893 | Christina Willey | Occupational Therapist | 210 W Walnut St, Canton, IL 61520-2444 | 2019-03-20 |
| 1487174744 | Joshua J Wilkinson | Nurse Practitioner | 210 W Walnut St, Canton, IL 61520-2444 | 2017-06-27 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1932530938 | Amy Sammis | Dietitian, Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2013-12-02 |
| 1609111988 | William Severt | Physical Therapist | 210 W Walnut St, Canton, IL 61520-2444 | 2012-11-28 |
| 1437448578 | Sandra Anne Haws | Dietitian, Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2011-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| 1568063428 | Mary J Eberle | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-11-05 |
| 1659970267 | Amanda Sue Kinne | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-10-23 |
| 1952879132 | Loft Rehabilitation and Nursing of Canton LLC | Skilled Nursing Facility | 2081 N Main St, Canton, IL 61520-1032 | 2018-11-06 |
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| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912315250 | Citadel Anesthesiology, LLC | Anesthesiology | 718 Silver Mist Way, Canton, GA 30114-8832 | 2014-07-30 |
| 1578704680 | John Killebrew Perry Jr. | Anesthesiology | 161 River Oaks Drive, Madison River Oaks Medical Center, Canton, MS 39046 | 2009-03-19 |
| 1700824224 | Sudha R Ravoori | Anesthesiology | 110 Edgewater Trl, Canton, GA 30115-1811 | 2006-06-04 |
| 1669422747 | Kristi L Pielstick | Anesthesiology | 4665 Douglas Cir Nw, Suite 101, Canton, OH 44718-3673 | 2006-05-11 |
| 1427483403 | United Pain Therapies Pllc | Anesthesiology | 6200 N Haggerty Rd, Canton, MI 48187-3605 | 2013-09-09 |
| 1124361720 | Michael John O'brien | Anesthesiology | 4665 Douglas Cir Nw, Canton, OH 44718-3673 | 2013-04-02 |
| 1770859761 | Elliot Michael Kay | Anesthesiology | 2600 6th St Sw, Canton, OH 44710-1702 | 2012-03-24 |
| 1417270885 | Anesthesiologists D.o., Inc | Anesthesiology | 4665 Douglas Cir Nw, Suite 101, Canton, OH 44718-3673 | 2010-03-12 |
| 1407178890 | Anesthesia Connections-ohio, LLC | Anesthesiology | 5000 Higbee Ave Nw, Canton, OH 44718-2522 | 2010-02-25 |
| 1942434592 | Southeastern Michigan Anesthesia | Anesthesiology | 42680 Ford Rd, Canton, MI 48187 | 2009-05-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.