Active NPI
Ilia S Panov, CRNA
- Certified Registered Nurse Anesthetist
- Libertyville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209007349
- Practice address
- 801 S Milwaukee Ave
Libertyville, IL 60048-3204 - Phone
- (847) 362-2905
- NPI assigned
- Dec 30, 2008
- Last updated
- Jul 17, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 209007349 | IL | Primary |
Addresses
Primary practice location
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ipanov238072@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Rush Medical College of Rush University, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 S Waukegan Rd
Suite 980
Lake Bluff, IL 60044-3013
Phone (847) 604-8700
214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 279-0061
801 S Milwaukee Ave BLDG
Suite 880
Libertryville, IL 60048-3204
Phone (847) 990-5910
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209007349 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Gastroenterology Group, LLC | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Northwest Gastroenterologists SC | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current | Accepting new patients | |
| Elgin Gastroenterology SC | Current | Accepting new patients | |
| Elgin Gastroenterology Endoscopy Center LLC | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240
29373 Network Pl
Chicago, IL 60673
745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362
101 Waukegan Rd
Lake Bluff, IL 60044
Phone (847) 604-8700
101 Waukegan Rd
Ste 980
Lake Bluff, IL 60044
Phone (847) 457-1060
801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900
900 Garfield Ave
Libertyville, IL 60048
Phone (847) 362-2900
2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246
1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150
1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000
Interoperability endpoints
- ipanov238072@direct.myadvocateaurora.org
Organizations & group practices 8
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.
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Gastroenterology Physician
- Elgin, IL
- NPI 1316277817
-
- Anesthesiology Physician
- Chicago, IL
- NPI 1255380184
-
dba Advocate Christ Medical Group
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
dba Advocate Children's Hospital
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
dba The Endo Center of Elgin Gastroenterology
- Ambulatory Surgical Clinic/Center
- Elgin, IL
- NPI 1992875454
-
- Gastroenterology Physician
- Elgin, IL
- NPI 1932291101
-
- Specialist
- Arlington Heights, IL
- NPI 1801886221
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Advocate Condell Imaging Center
- Mobile Mammography Clinic/Center
- Gurnee, IL
- NPI 1023262441
Hospital
-
- General Acute Care Hospital
- Libertyville, IL
- NPI 1124272547
-
dba Advocate Condell Medical Center Grays Lake
- Mobile Mammography Clinic/Center
- Grayslake, IL
- NPI 1770737199
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1588800296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S MILWAUKEE AVE",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483204",
"telephone_number": "847-362-2905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANOV",
"first_name": "ILIA",
"middle_name": "S",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-30",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209007349",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ipanov238072@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "801 S Milwaukee Ave",
"city": "Libertyville",
"state": "IL",
"country_code": "US",
"postal_code": "600483204",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "801 S Milwaukee Ave",
"city": "Libertyville",
"state": "IL",
"country_code": "US",
"postal_code": "600483204",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.