Individual provider Active NPI

Robert J Rady, CRNA

  • Certified Registered Nurse Anesthetist
  • Tinley Park, IL
National Provider Identifier
1407903719
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Practice address
17954 Highland Ave
Tinley Park, IL 60477-4269
Phone
(708) 614-7588
Fax
(708) 614-6588
NPI assigned
Jan 5, 2007
Last updated
Jan 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

17954 Highland Ave
Tinley Park, IL 60477-4269

Mailing address

17954 Highland Ave
Tinley Park, IL 60477-4269
Phone (708) 614-7588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060302000029 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395707822 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209003550ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Medical Specialist Inc CurrentSince May 15, 2023 Accepting new patients
The Pain Center of Illinois Inc. CurrentSince May 15, 2023 Accepting new patients
Bob Rady, Inc Nurse Anesthetist, Certified Registered PastSince Mar 15, 2001 Accepting new patients
Sure Work Health Clinic LTD Past Accepting new patients
Multicare Physician Center PC PastSince Mar 4, 2019 Accepting new patients

Locations

688 Cedar Crossings Dr
New Lenox, IL 60451
Phone (815) 727-3030

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1407903719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17954 HIGHLAND AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774269",
            "telephone_number": "708-614-7588",
            "fax_number": "708-614-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17954 HIGHLAND AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774269",
            "telephone_number": "708-614-7588",
            "fax_number": "708-614-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADY",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-01-09",
        "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 Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.