Individual provider Active NPI

Leah Theresa Olsson, CRNA

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1508195454
Registry record updated Sep 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.007933 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1447
Phone
(630) 781-3069
NPI assigned
Dec 23, 2009
Last updated
Sep 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2010

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 209.007933 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1447

Mailing address

2089 W Wabansia Ave
304
Chicago, IL 60647-5602
Phone (620) 781-3069

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181226001313 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204010804 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rush Medical College of Rush University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209.007933ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Services, LLC CurrentSince Oct 17, 2018 Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
Northwestern Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 17, 2018 Accepting new patients
West Michigan Aas LLC CurrentSince Nov 1, 2022 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Aug 27, 2021 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

18100 Oakwood Blvd
Ste 100
Dearborn, MI 48124
Phone (313) 240-7668

30055 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 626-8200

30055 Northwestern Hwy
Ste L-60
Farmington Hills, MI 48334
Phone (248) 265-6555

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

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": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284163200000",
    "number": "1508195454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 W WABANSIA AVE",
            "address_2": "304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475602",
            "telephone_number": "620-781-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "630-781-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSSON",
        "first_name": "LEAH",
        "middle_name": "THERESA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2010-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.007933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2010; 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.