Active NPI
Eileen Boetel, CRNA
- Certified Registered Nurse Anesthetist
- Lansing, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 28078166A
- Practice address
- 18221 Torrence Ave
Lansing, IL 60438-2870 - Phone
- (708) 895-9450
- NPI assigned
- May 27, 2006
- Last updated
- May 20, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 28078166A | IN | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 209.005883 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 17767330 | WI |
Addresses
Primary practice location
18221 Torrence Ave
Lansing, IL 60438-2870
Mailing address
552 Fleetwood Dr N
Valparaiso, IN 46385-6806
Phone (219) 929-6982
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200542180 | Medicaid | IN | |
| 000000610944 | Other | IN | ANTHEM PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, IL, MI
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
1601 W Lincoln Rd
Kokomo, IN 46902-3275
Phone (765) 453-5696
18221 Torrence Ave
Suite 1B
Lansing, IL 60438-2870
Phone (708) 895-9450
201 Main St
Hobart, IN 46342-4439
Phone 2194767246321
6712 N Convent St
Bourbonnais, IL 60914-1528
Phone (815) 348-9500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.005883 | IL | MD | Certified Registered Nurse Anesthetist |
| 17767330 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Colleagues LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Sda Consultants PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| United Surgeons, LLC | Current | Accepting new patients | |
| Stat Anesthesia Specialists LTD | Current | Accepting new patients | |
| Jebs Anesthesia Consultants, LLC | Current | Accepting new patients | |
| Clinical Colleagues LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Porter County Anesthesia Associates PC | Past | Accepting new patients | |
| Anesthesia Consultants of Indiana, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Windy City Anesthesia PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Windy City Anesthesia PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
6712 N Convent St
Bourbonnais, IL 60914
Phone (815) 348-9500
695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-0557
18221 Torrence Ave
Ste 1B
Lansing, IL 60438
Phone (708) 474-7600
500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683
7747 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-9104
1601 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 453-5696
3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498
3930 Edison Lakes Pkwy
Ste 100
Mishawaka, IN 46545
4455 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 231-6134
9200 Calumet Ave
Ste S100
Munster, IN 46321
Phone (219) 576-6260
10220 Wicker Ave
Ste 3
Saint John, IN 46373
Phone (219) 515-6943
Interoperability endpoints
- eileen.boetel.1@16383.direct.athenahealth.com
Organizations & group practices 14
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.
-
- Anesthesiology Physician
- Galesburg, IL
- NPI 1316399967
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- La Porte, IN
- NPI 1790447761
-
- Pain Medicine Physician
- La Porte, IN
- NPI 1790920452
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1336605500
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Saint John, IN
- NPI 1699724781
-
dba Unity Physicians Hospital
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1518197011
-
dba Apac, PC
- Pain Medicine (Anesthesiology) Physician
- Crown Point, IN
- NPI 1457387078
-
- Certified Registered Nurse Anesthetist
- Crown Point, IN
- NPI 1013475375
IL
-
- Anesthesiology Physician
- Van Wert, OH
- NPI 1992725766
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Frankfort, IL
- NPI 1932248622
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Pittsburgh, PA
- NPI 1417974494
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1407803265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "552 FLEETWOOD DR N",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463856806",
"telephone_number": "219-929-6982",
"fax_number": "219-464-7221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18221 TORRENCE AVE",
"city": "LANSING",
"state": "IL",
"postal_code": "604382870",
"telephone_number": "708-895-9450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOETEL",
"first_name": "EILEEN",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-27",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IN",
"license": "28078166A",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209.005883",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "17767330",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200542180",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000610944",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.