Individual provider Active NPI

Teresa Lacek, CRNA

  • Certified Registered Nurse Anesthetist
  • Dekalb, IL
National Provider Identifier
1154617769
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.008841 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 756-1521
NPI assigned
Jun 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209.008841 IL Primary

Addresses

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (800) 242-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110928000886 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214108943 Reassigns benefits to 6 organizations
I20140611000698 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214108943

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Anesthesia Providers LTDGroup PAC ID 6709249006, 26 clinicians

Practice addresses (Care Compare)

19110 Darvin Dr
Suite a
Mokena, IL 60448-8683
Phone (708) 478-8889

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.008841ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Anesthesia Providers, LTD Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2023 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Sep 24, 2019 Accepting new patients
Valley Pain Care Centers LTD CurrentSince Apr 7, 2012 Accepting new patients
Core Anesthesia PLLC CurrentSince Jul 2, 2019 Accepting new patients
Quantum Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 23, 2017 Accepting new patients

Locations

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

3536 W Fullerton Ave
Chicago, IL 60647
Phone (773) 772-1212

4849 W Fullerton Ave
Chicago, IL 60639
Phone (773) 237-2900

10400 Southwest Hwy
Chicago Ridge, IL 60415
Phone (708) 423-8706

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

114 W Rockland Rd
Libertyville, IL 60048
Phone (773) 267-0554

19110 Darvin Dr
Mokena, IL 60448
Phone (708) 478-8889

19110 Darvin Dr
Ste A
Mokena, IL 60448
Phone (708) 478-8889

1003 Pawlak Pkwy
New Lenox, IL 60451
Phone (708) 226-3300

14404 John Humphrey Dr
Orland Park, IL 60462
Phone (708) 671-1264

10 Orland Square Dr
Ste 10C
Orland Park, IL 60462
Phone (708) 942-6030

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

7340 W College Dr
Fl 1
Palos Heights, IL 60463
Phone (708) 361-3233

10330 S Roberts Rd
Palos Hills, IL 60465
Phone (708) 237-7200

1879 N Neltnor Blvd
West Chicago, IL 60185

9200 Calumet Ave
Ste 200
Munster, IN 46321
Phone (219) 961-9621

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1154617769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-242-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEK",
        "first_name": "TERESA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.008841",
            "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 Jun 22, 2011; 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.