Individual provider Active NPI

Susan Rettig, CRNA

  • Certified Registered Nurse Anesthetist
  • Pekin, IL
National Provider Identifier
1386738268
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Practice address
600 S 13TH St
Pekin, IL 61554-4936
Phone
(309) 353-0406
Fax
(309) 347-1240
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

600 S 13TH St
Pekin, IL 61554-4936

Mailing address

346 E Eller Dr
East Peoria, IL 61611-5417
Phone (309) 282-6417

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323000872 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779474358 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4281

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041267358ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
McDonough County Hospital District CurrentSince Aug 7, 2014 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Aug 7, 2014 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2018 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Decatur Memorial Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Associated Anesthesiologists, S.C. Past Accepting new patients
Decatur Memorial Hospital Past Accepting new patients

Locations

2300 N Edward St
Ste 1910
Decatur, IL 62526
Phone (217) 876-2645

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

101 S Major St
Eureka, IL 61530
Phone (309) 268-2172

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

1001 Main St
Ste 500A
Peoria, IL 61606
Phone (309) 672-4980

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386738268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 E ELLER DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616115417",
            "telephone_number": "309-282-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S 13TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544936",
            "telephone_number": "309-353-0406",
            "fax_number": "309-347-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "SUSAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.