Souphaphone Bounmythavong (NPI# 1740425701, PAC ID# 2567517691) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1740425701 |
| PAC ID by PECOS | 2567517691 |
| Professional Enrollment ID | I20120323000591 |
| Full Name | Souphaphone Bounmythavong |
| Organization Legal Name | VALLEY AMBULATORY SURGERY CENTER ANESTHESIA LTD. |
| Address |
2210 Dean St St Charles IL 60175-1066 |
| Phone Number | 6305849800 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 0345225116 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2210 Dean St, St Charles, IL 60175-1066 | 6305849800 | VALLEY AMBULATORY SURGERY CENTER ANESTHESIA LTD. |
| Organization Legal Name | VALLEY AMBULATORY SURGERY CENTER ANESTHESIA LTD. |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maria N Quartetti | Anesthesiology | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Erin D Browning | Certified Registered Nurse Anesthetist (crna) | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Robert Berg | Anesthesiology | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Jane E Fanslow | Certified Registered Nurse Anesthetist (crna) | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Kayla Weck | Certified Registered Nurse Anesthetist (crna) | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Street Address |
2210 DEAN ST |
| City | ST CHARLES |
| State | IL |
| Zip | 60175-1066 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daryn Abraham | Allergy/immunology | 2210 Dean St, Suite M, St Charles, IL 60175-1059 | |
| Maria N Quartetti | Anesthesiology | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Erin D Browning | Certified Registered Nurse Anesthetist (crna) | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| David A Glenn | Chiropractic | 2210 Dean St, Suite F, Saint Charles, IL 60175-1059 | |
| Robert Berg | Anesthesiology | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Ernest V Isadore | Podiatry | 2210 Dean St, C, St Charles, IL 60175-1059 | |
| Jane E Fanslow | Certified Registered Nurse Anesthetist (crna) | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Kayla Weck | Certified Registered Nurse Anesthetist (crna) | Valley Ambulatory Surgery Center Anesthesia Ltd. | 2210 Dean St, St Charles, IL 60175-1066 |
| Richard T Meyer Jr. | Allergy/immunology | Allergy and Asthma Medical Associates | 2210 Dean St, M, St Charles, IL 60175-1059 |
| Dennis A Long | Psychiatry | Dennis A. Long Md Sc | 2210 Dean St, Suite I, Saint Charles, IL 60175-1067 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ginny M Dobbins | Physical Therapy | Advanced Physical Medicine of Saint Charles | 3381 W Main St, Suite 1, St Charles, IL 60175-1008 |
| Anthony V Pollastrini | Podiatry | 3381 W Main St, Suite 2, Saint Charles, IL 60175-1008 | |
| Andrew Raymond Glenn | Chiropractic | Advanced Physical Medicine of Saint Charles | 3381 W Main St, Suite 1, St Charles, IL 60175-1008 |
| David A Williamson | Chiropractic | Advanced Physical Medicine of Saint Charles | 3381 W Main St, Suite 1, St Charles, IL 60175-1008 |
| James E Judge | Chiropractic | 2422 W Main St, 4a, Saint Charles, IL 60175-1010 | |
| Kalie E Judge | Chiropractic | 2422 W Main St, 4a, St Charles, IL 60175-1010 | |
| Maria Holgado Cocjin | Pediatric Medicine | Dreyer Clinic Inc | 3310 W Main St, Suite 200, St Charles, IL 60175-1024 |
| Kelly C Simkins | Obstetrics/gynecology | Dreyer Clinic Inc | 3310 W Main St, Suite 200, St Charles, IL 60175-1024 |
| Raja Chatterji | Obstetrics/gynecology | Dreyer Clinic Inc | 3310 W Main St, Suite 200, St Charles, IL 60175-1024 |
| Sarah E Smith | Pediatric Medicine | Dreyer Clinic Inc | 3310 W Main St, Suite 200, St Charles, IL 60175-1024 |
| Find all physicians in zip 60175 | |||
| City | ST CHARLES |
| Zip Code | 60175 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | ST CHARLES + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.