| Dr Lanny R South, DO | |
| 
					21120 Washington Pkwy, Frankfort, IL 60423-3112  | |
| (815) 469-9750 | |
| Not Available | 
| Full Name | Dr Lanny R South | 
|---|---|
| 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 | 
|---|---|
| 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 | 
|---|---|
| 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  |