Individual provider Active NPI

Paul Matter

  • Certified Registered Nurse Anesthetist
  • McHenry, IL
National Provider Identifier
1477296556
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209025407 Issued in IL
Practice address
4309 W Medical Center Dr Ste A201
McHenry, IL 60050-8411
Phone
(815) 385-0084
NPI assigned
Apr 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209025407 IL Primary
Critical Care Medicine Registered Nurse 163WC0200X 041437972 IL
Certified Registered Nurse Anesthetist 367500000X 041437972 IL

Addresses

Primary practice location

4309 W Medical Center Dr Ste A201
McHenry, IL 60050-8411

Mailing address

16928 Boulder Way
Macomb, MI 48042-3516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810002404 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284017138 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
R Franklin University of Med & Sci/Chicago Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Brook Anesthesiologists LTDGroup PAC ID 3870554298, 20 clinicians
Town Square Anesthesia LLCGroup PAC ID 9335047455, 21 clinicians
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Practice addresses (Care Compare)

2425 W 22ND St
Suite 101
Oak Brook, IL 60523-4642
Phone (630) 990-2212

2550 W Algonquin Rd
Lake in the Hills, IL 60156-3503
Phone (847) 458-1246

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 422-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041437972ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Feb 26, 2024 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients
Oak Brook Anesthesiologists, LTD. CurrentSince Mar 13, 2025 Accepting new patients
Gip Anesthesia Services PLLC CurrentSince Jun 1, 2025 Accepting new patients
Town Square Anesthesia LLC CurrentSince Apr 25, 2025 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2022 Accepting new patients
Huntley Anesthesia Associates LLC CurrentSince Jul 15, 2022 Accepting new patients

Locations

1580 W Lake St
Ste 100
Addison, IL 60101
Phone (630) 285-7000

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

2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311

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

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

22285 N Pepper Rd
Ste 312
Lake Barrington, IL 60010
Phone 84738206793336

22285 N Pepper Rd
Lake Barrington, IL 60010
Phone (224) 357-8133

1880 W Winchester Rd
Ste 104
Libertyville, IL 60048

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

2425 W 22nd St
Ste 101
Oak Brook, IL 60523
Phone (630) 312-5000

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

3703 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

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

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 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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1477296556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16928 BOULDER WAY",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480423516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A201",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508411",
            "telephone_number": "815-385-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTER",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209025407",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041437972",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041437972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.