Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Premier Anesthesia of Illinois Professional Corporation

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1932089778

Premier Anesthesia of Illinois Professional Corporation is an Oral & Maxillofacial Surgery (D.M.D.) in Kankakee, Illinois. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
7

Practice location Address checks out

375 N Wall St
Kankakee, IL 60901-3483
Phone: (855) 369-7546
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X
Pediatric Anesthesiology Physician Taxonomy 207LP3000X
Pain Medicine Physician Taxonomy 208VP0000X
Interventional Pain Medicine Physician Taxonomy 208VP0014X
Certified Registered Nurse Anesthetist Taxonomy 367500000X

Record details

NPI number1932089778
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Randy Walker — Vp · (678) 690-7812
NPI enumeratedSeptember 3, 2025
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025
Mailing address2655 Northwinds Pkwy, Alpharetta, GA 30009-2280