Individual provider Active NPI

Jared Konner

  • Anesthesiology Physician
  • Naperville, IL
National Provider Identifier
1407316581
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036162370 Issued in IL
Practice address
801 S Washington St
Naperville, IL 60540-7430
Phone
(630) 527-3000
NPI assigned
Mar 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036162370 IL Primary

Addresses

Primary practice location

801 S Washington St
Naperville, IL 60540-7430

Mailing address

813 S Charles Ave
Naperville, IL 60540-7608
Phone (201) 394-6041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916002985 IL Practitioner - Anesthesiology 8921333543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Nova Southeastern College of Osteo Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Valley Anesthesiologists LTDGroup PAC ID 6305747890, 62 clinicians

Practice addresses (Care Compare)

815 Pasquinelli Dr
Westmont, IL 60559-1276
Phone (630) 654-2515

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036162370ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Valley Anesthesiologists, LTD. Anesthesiology CurrentSince Aug 1, 2024 Accepting new patients

Locations

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

815 Pasquinelli Dr
Westmont, IL 60559
Phone (630) 366-7854

Organizations & group practices 1

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 1

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": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1407316581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 S CHARLES AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407608",
            "telephone_number": "201-394-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407430",
            "telephone_number": "630-527-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONNER",
        "first_name": "JARED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2024-07-16",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036162370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.