Individual provider Active NPI

Teresa A Mitchell, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • Winfield, IL
National Provider Identifier
1386914653
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209009365 Issued in IL
Practice address
25 N Winfield Rd
Winfield, IL 60190-1379
Phone
(630) 933-6675
Fax
(630) 933-2614
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 209009365 IL Primary

Addresses

Primary practice location

25 N Winfield Rd
Winfield, IL 60190-1379

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1379
Phone (630) 933-6675

Other identifiers 1

IdentifierTypeStateIssuer
089586OtherAANA NUMBER

Other names 1

  • Teresa A Franklin Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmitchell97255@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120611000350 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103080759 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Cincinnati College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 19, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 19, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Nov 12, 2018 Accepting new patients
Loyola University Medical Center CurrentSince Nov 12, 2018 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Jan 5, 2013 Accepting new patients
Tippecanoe Anesthesia Services LLC Past Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1386914653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-933-6675",
            "fax_number": "630-933-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-933-6675",
            "fax_number": "630-933-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TERESA",
        "middle_name": "A",
        "credential": "APRN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209009365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA NUMBER",
            "identifier": "089586",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmitchell97255@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "FRANKLIN",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.

Verify at the official NPI Registry.