Individual provider Active NPI

David J Nowak, CRNA

  • Pain Medicine (Anesthesiology) Physician
  • Dekalb, IL
National Provider Identifier
1114929023
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Practice address
3319 Meadow TRL W
Dekalb, IL 60115-5327
Phone
(815) 758-3636
NPI assigned
Aug 10, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 209-04039 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X IL Primary

Addresses

Primary practice location

3319 Meadow TRL W
Dekalb, IL 60115-5327

Mailing address

3319 Meadow TRL W
Dekalb, IL 60115-5327
Phone (815) 758-3636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000613 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456319573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041-298004ILMDPain Medicine (Anesthesiology) Physician
209-04039ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Gottlieb Midwest Anesthesiologists, LLC Past Accepting new patients
Figueroa and Associates Anesthesia Group, LTD. Past Accepting new patients
Anesthesia Associates, LTD Pain Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dnowak19801@cghmc.direct-ci.com
  • Direct secure messaging: dnowak806358@direct.unitypoint.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114929023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 MEADOW TRL W",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601155327",
            "telephone_number": "815-758-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 MEADOW TRL W",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601155327",
            "telephone_number": "815-758-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "209-04039",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.