Individual provider Active NPI

Alexander Stukalov, M.D

  • Anesthesiology Physician
  • Park Ridge, IL
National Provider Identifier
1467488205
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
45773 Issued in WI
Practice address
1775 W Dempster St
Park Ridge, IL 60068-1143
Phone
(847) 723-2210
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036110012 IL
Anesthesiology Physician 207L00000X 45773 WI Primary

Addresses

Primary practice location

1775 W Dempster St
Park Ridge, IL 60068-1143

Mailing address

255 W Michigan Ave
PO Box 1123
Jackson, MI 49201-2218
Phone (517) 787-6440

Other practice location 1

1000 North Oak Avenue
Marshfield, WI 54449-5703
Phone (715) 387-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040818001263 IL Practitioner - Anesthesiology 9335112184 Reassigns benefits to 3 organizations
I20210320000066 WI Practitioner - Anesthesiology 9335112184 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, shared by 28 NPIs, 1,195 clinicians
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

5666 E State St
Rockford, IL 61108-2425
Phone (815) 226-2000

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110012ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Mar 19, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Mar 19, 2025 Accepting new patients
MCHS Hospitals Inc Anesthesiology Current Accepting new patients
Flambeau Hospital Inc CurrentSince Mar 19, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 19, 2025 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Jun 28, 2021 Accepting new patients
Flambeau Hospital Inc CurrentSince Mar 19, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Mar 19, 2025 Accepting new patients
Quantum Anesthesia Services LLC CurrentSince Jun 20, 2020 Accepting new patients
Metro Milwaukee Anesthesia Associates SC CurrentSince Jan 1, 2021 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Mar 19, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Mar 19, 2025 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Mar 19, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Mar 19, 2025 Accepting new patients

Locations

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

3536 W Fullerton Ave
Chicago, IL 60647
Phone (773) 772-1212

21120 Washington Pkwy
Frankfort, IL 60423
Phone (815) 469-9750

114 W Rockland Rd
Libertyville, IL 60048
Phone (773) 267-0554

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

15324 W Beloit Rd
Ste 300A
New Berlin, WI 53151
Phone (414) 761-0981

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 16

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.

View all 16

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1467488205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 North Oak Avenue",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUKALOV",
        "first_name": "ALEXANDER",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036110012",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "45773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.