Active NPI
Yelena Polyakov, CRNA
- Certified Registered Nurse Anesthetist
- Evanston, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209-005841
- Practice address
- 2650 Ridge Ave
Anesthesiology, RM 3905
Evanston, IL 60201-1718 - Phone
- (847) 570-2760
- Fax
- (847) 570-2921
- NPI assigned
- Feb 17, 2007
- Sex
- Female
- 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 | 209-005841 | IL | Primary |
Addresses
Primary practice location
2650 Ridge Ave
Anesthesiology, RM 3905
Evanston, IL 60201-1718
Mailing address
2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1206
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209-005841 | Other | IL | IL STATE LIC |
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
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Hospital & facility affiliations
- Loyola University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-005841 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Midwest Anesthesia Partners, LLC | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Gottlieb Midwest Anesthesiologists, LLC | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients |
Locations
9609 Eagle Way
Chicago, IL 60678
Phone (866) 552-7288
2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240
9532 Eagle Way
Chicago, IL 60678
9145 Collection Ctr Dr
Chicago, IL 60693
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Rm 3905
Evanston, IL 60201
Phone (847) 570-2760
2100 Pfingsten Rd
Glenview, IL 60026
Phone (847) 657-5800
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
2160 S 1st Ave
Bldg 101
Maywood, IL 60153
Phone (708) 216-8785
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
15300 West Ave
Ste 260
Orland Park, IL 60462
Phone (708) 460-5550
530 N Cass Ave
Westmont, IL 60559
Phone (630) 794-8688
Interoperability endpoints
- ypolyakov34485@direct.luhs.org
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 and National Provider Directory roles.
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
- Anesthesiology Physician
- Melrose Park, IL
- NPI 1003832767
-
- Anesthesiology Physician
- Chicago, IL
- NPI 1255380184
-
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659415107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"address_2": "EVANSTON HOSPITAL",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718",
"telephone_number": "847-570-1206",
"fax_number": "847-570-1248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"address_2": "ANESTHESIOLOGY, RM 3905",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718",
"telephone_number": "847-570-2760",
"fax_number": "847-570-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLYAKOV",
"first_name": "YELENA",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209-005841",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL STATE LIC",
"identifier": "209-005841",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.