Active NPI
Anthony Enrico
- Certified Registered Nurse Anesthetist
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209023436
- Practice address
- 5666 E State St
Rockford, IL 61108-2425 - Phone
- (815) 226-2000
- NPI assigned
- May 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041442697 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 209023436 | IL | Primary |
Addresses
Primary practice location
5666 E State St
Rockford, IL 61108-2425
Mailing address
1911 Ridgeland Rd
Rockford, IL 61108-6321
Phone (815) 713-8107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100
5666 E State St
Rockford, IL 61108-2425
Phone (815) 226-2000
Hospital & facility affiliations
- Saint Anthony Medical Center
- Osf Saint Paul Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041442697 | IL | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gip Anesthesia Services PLLC | Current | Accepting new patients | |
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| Town Square Anesthesia LLC | Current | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
22285 N Pepper Rd
Lake Barrington, IL 60010
Phone (224) 357-8133
22285 N Pepper Rd
Ste 312
Lake Barrington, IL 60010
Phone 84738206793336
1880 W Winchester Rd
Ste 104
Libertyville, IL 60048
2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246
5666 E State St
Rockford, IL 61108
Phone (815) 226-2000
3703 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170
68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
-
- Anesthesiology Physician
- Lake Barrington, IL
- NPI 1821733726
-
- Anesthesiology Physician
- Woodstock, IL
- NPI 1669471017
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Mendota, IL
- NPI 1609803113
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1790739977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1003499278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 RIDGELAND RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611086321",
"telephone_number": "815-713-8107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5666 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082425",
"telephone_number": "815-226-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENRICO",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-04",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041442697",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209023436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.