Gwen M Markham, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209-003239 Issued in IL

Practice address

350 N Wall St
Kankakee, IL 60901-2901

Phone

(815) 993-1671

Fax

(815) 936-6971

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

American Anesthesiology Associates of Illinois, S.C.Group PAC ID 3971498924, 50 clinicians

North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Premier Anesthesia of Illinois Professional CorporationGroup PAC ID 1254826175, 42 clinicians

Novus Illinois Service CorporationGroup PAC ID 6901293786, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• North American Partners in Anesthesia (Illinois), LLC

  • Anesthesiology Physician
  • Oak Park, IL
  • NPI 1699032524
  Medicare reassignment Care Compare group NPD
• Novus Illinois Service Corporation

  • Anesthesiology Physician
  • Kankakee, IL
  • NPI 1295491744

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Premier Anesthesia of Illinois Professional Corporation

  • Anesthesiology Physician
  • Kankakee, IL
  • NPI 1932089778

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• American Anesthesiology Associates of Illinois, S.C.

  • Anesthesiology Physician
  • Mokena, IL
  • NPI 1962512335
  Medicare reassignment Care Compare group

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

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1326191636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13749",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013749",
            "telephone_number": "855-447-2240",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-993-1671",
            "fax_number": "815-936-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKHAM",
        "first_name": "GWEN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-286365",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-003239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA",
            "identifier": "51835",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manor Care of Kankakee Il LLC
• Vicky Lynn Mansberger, R.D.
• Thomas Paul Marcotte, RPH
• Andrew Tariao Mariano, DO
• Sara Joy Marion, PTA
• Christine Marneris, M.A., CCC-A
• Andrea Marquez, BSN
• Deborah Mofoluwa Marshall
• Perry Marshall, D.O
• Abigail M Martinez, M.D.

• Certified Registered Nurse Anesthetist in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.