Individual provider Active NPI

Glenn Stech, CRNA

  • Certified Registered Nurse Anesthetist
  • Mahomet, IL
National Provider Identifier
1639366818
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209002404 Issued in IL
Practice address
611 N Craig Dr
Mahomet, IL 61853-9054
Phone
(217) 621-9550
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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 209002404 IL Primary

Addresses

Primary practice location

611 N Craig Dr
Mahomet, IL 61853-9054

Mailing address

611 N Craig Dr
Mahomet, IL 61853-9054

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040320000603 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365333440 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209002404ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Dec 1, 2023 Accepting new patients
Christie Clinic, PLLC PastSince May 15, 2001 Accepting new patients
American Anesthesiology of Illinois, LLC Past Accepting new patients
Premier Anesthesia of Urbana Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

998 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 744-3000

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1639366818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N CRAIG DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618539054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N CRAIG DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618539054",
            "telephone_number": "217-621-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STECH",
        "first_name": "GLENN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209002404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahomet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.