Active NPI
Sunyang Lee, CRNA
- Certified Registered Nurse Anesthetist
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209030033
- Practice address
- 6742 N Frostwood Pkwy
Peoria, IL 61615-2402 - Phone
- (309) 692-5393
- Fax
- (309) 683-9998
- NPI assigned
- Jul 24, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 2016006196 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 209030033 | IL | Primary |
Addresses
Primary practice location
6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Mailing address
661 Harding Rd Apt 210C
Morton, IL 61550-0515
Phone (417) 379-6991
Other practice location 1
661 Harding Rd Apt 201C
Morton, IL 61550-0515
Phone (417) 379-6991
Other names 1
- Sunyang Park
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, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016006196 | MO | MD | General Practice Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Anesthesiologists, S.C. | Current | Accepting new patients | |
| Associated Anesthesiologists, SC | Current | Accepting new patients |
Locations
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
Organizations & group practices 2
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
- Peoria, IL
- NPI 1558306480
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725580800000",
"number": "1336829431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "661 HARDING RD APT 210C",
"city": "MORTON",
"state": "IL",
"postal_code": "615500515",
"telephone_number": "417-379-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6742 N FROSTWOOD PKWY",
"city": "PEORIA",
"state": "IL",
"postal_code": "616152402",
"telephone_number": "309-692-5393",
"fax_number": "309-683-9998"
}
],
"practiceLocations": [
{
"address_1": "661 Harding Rd Apt 201C",
"address_purpose": "LOCATION",
"city": "Morton",
"state": "IL",
"postal_code": "615500515",
"country_code": "US",
"telephone_number": "417-379-6991",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "SUNYANG",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-24",
"last_updated": "2024-09-06",
"certification_date": "2024-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "MO",
"license": "2016006196",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209030033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUNYANG",
"last_name": "PARK",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.