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

Granite City Clinic Corp

Organization Anesthesiology Physician · NPI 1003892464

Granite City Clinic Corp provides Anesthesiology Physician services in Granite City, Illinois. Registered with an NPI since 2005.

In the registry since
2005
Specialties on file
2
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2100 Madison Ave
Granite City, IL 62040-4701 Not confirmed with CMS for 19 years — call before visiting
Phone: (618) 798-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X
Anesthesiology Physician Taxonomy 207L00000X

Record details

NPI number1003892464
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Newsome — Vp · (615) 465-7000
Other names Granite City Anesthesia
NPI enumeratedDecember 19, 2005
Last updated in NPPESJuly 30, 2007
Mailing addressP O Box 503734, Saint Louis, MO 63150-0001

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