| Mr Walter Laesch, CRNA | |
|
40 10 Riverknoll Dr, Champaign, IL 61822 | |
| (217) 356-5963 | |
| (217) 352-8947 |
| Full Name | Mr Walter Laesch |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 40 10 Riverknoll Dr, Champaign, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639152952 | NPI | - | NPPES |
| 09223524 | Other | IL | BC/BS GROUP ID NO. |
| 371390028001 | Other | IL | TRICARE GROUP ID NO. |
| 216564000 | Other | IL | WORKMAN'S COMP GROUP ID |
| CG3273 | Other | IL | RR MEDICARE GROUP ID NO. |
| 430052840 | Other | IL | RR MEDICARE GROUP ID NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209-000371 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Walter Laesch, CRNA 1016 W Union St, Champaign, IL 61821-3322 Ph: (217) 359-2752 | Mr Walter Laesch, CRNA 40 10 Riverknoll Dr, Champaign, IL 61822 Ph: (217) 356-5963 |
Mr. Jerome W. Wellinghoff, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4010 Riverknoll Dr, Champaign, IL 61822 Phone: 217-356-5963 Fax: 217-352-8947 | |
Carol A Reeb, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1702 S Mattis Ave, Anesthesiology, Champaign, IL 61821 Phone: 217-326-2000 Fax: 217-326-2016 | |
Mrs. Theresa Marie Swift, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2001 N Mattis Ave Unit 7230, Champaign, IL 61826 Phone: 217-840-1419 | |
Andrew Moody, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1701 Curtis Rd, Champaign, IL 61822 Phone: 217-365-6206 |