Dr Lanny R South, DO | |
21120 Washington Pkwy, Frankfort, IL 60423-3112 | |
(815) 469-9750 | |
Not Available |
Full Name | Dr Lanny R South |
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Gender | Male |
Speciality | Anesthesiology |
Location | 21120 Washington Pkwy, Frankfort, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215996582 | NPI | - | NPPES |
255138100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | OS7770 (Florida) | Secondary |
207L00000X | Anesthesiology | 34.006388 (Ohio) | Secondary |
207L00000X | Anesthesiology | 036.131960 (Illinois) | Primary |
Entity Name | Northstar Anesthesia Of Ohio Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417276429 PECOS PAC ID: 3173648300 Enrollment ID: O20100927000005 |
Mailing Address | Practice Location Address |
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Dr Lanny R South, DO 21120 Washington Pkwy, Frankfort, IL 60423-3112 Ph: (815) 469-9750 | Dr Lanny R South, DO 21120 Washington Pkwy, Frankfort, IL 60423-3112 Ph: (815) 469-9750 |
Dr. Jalaja V. Piska, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10095 W Lincoln Hwy, Frankfort, IL 60423 Phone: 815-806-0400 Fax: 815-806-0406 | |
Juliet Goldsher, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21120 Washington Pkwy, Frankfort, IL 60423 Phone: 815-469-9750 Fax: 815-469-9752 |