Individual provider Active NPI

Louise E Komorek, CRNA

  • Certified Registered Nurse Anesthetist
  • Granite City, IL
National Provider Identifier
1366577835
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209006533 Issued in IL
Practice address
2100 Madison Ave
Granite City, IL 62040-4701
Phone
(660) 826-5960
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 209006533 IL Primary

Addresses

Primary practice location

2100 Madison Ave
Granite City, IL 62040-4701

Mailing address

PO Box 1547
Sedalia, MO 65302-1547

Other names 1

  • Louise E Weise Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkomorek227863@direct.luhs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070612000128 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658479894 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola Medical Group LLC CurrentSince Jan 1, 2023 Accepting new patients
Mount Sinai Community Foundation CurrentSince Oct 22, 2016 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Aug 8, 2023 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Sinai Community Foundation CurrentSince Oct 22, 2016 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Aug 8, 2023 Accepting new patients
Encore Anesthesia Group LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2021 Accepting new patients
Physician Anesthesia Associates, S.C. Past Accepting new patients
Granite City Physicians Corp Past Accepting new patients

Locations

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

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

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

125 N La Grange Rd
La Grange, IL 60525
Phone (708) 354-4900

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

Organizations & group practices 9

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1366577835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404701",
            "telephone_number": "660-826-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOREK",
        "first_name": "LOUISE",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209006533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkomorek227863@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2100 Madison Ave",
            "city": "Granite City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620404701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LOUISE",
            "last_name": "WEISE",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.