Individual provider Active NPI

Eunice W Mudryj, CRNA

  • Certified Registered Nurse Anesthetist
  • Joliet, IL
National Provider Identifier
1063429959
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209002003 Issued in IL
Practice address
1200 Maple Rd
Joliet, IL 60432-1439
Phone
(815) 740-1100
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 041251265 IL
Certified Registered Nurse Anesthetist 367500000X 209002003 IL Primary

Addresses

Primary practice location

1200 Maple Rd
Joliet, IL 60432-1439

Mailing address

185 Penny Ave
East Dundee, IL 60118-1454
Phone (847) 836-7015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040417000468 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355336413 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041251265ILMDCertified Registered Nurse Anesthetist
209002003ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Nov 8, 2023 Accepting new patients
Allied Anesthesia Associates, P.C. Past Accepting new patients
MN Anesthesia LLC Past Accepting new patients
Southwest Anesthesia Consultants, LLC Past Accepting new patients
University Anesthesiologists SC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

998 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 744-3000

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1063429959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PENNY AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181454",
            "telephone_number": "847-836-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MAPLE RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604321439",
            "telephone_number": "815-740-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRYJ",
        "first_name": "EUNICE",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041251265",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209002003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.