Active NPI
Craig R McCloud, CRNA
- Pain Medicine (Anesthesiology) Physician
- Dekalb, IL
National Provider Identifier
1689676694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- Practice address
- 626 Bethany Rd
Dekalb, IL 60115-4939 - Phone
- (815) 748-8993
- NPI assigned
- Aug 10, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | IL | Primary | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | IL |
Addresses
Primary practice location
626 Bethany Rd
Dekalb, IL 60115-4939
Mailing address
6910 S Madison St
Willow Brook, IL 60527-5504
Phone (815) 748-8993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-112016 | IL | MD | Pain Medicine (Anesthesiology) Physician |
| 209-000815 | IL | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guardian Anesthesia Associates, S.C | Past | Accepting new patients | |
| Anesthesia Associates, LTD | Pain Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pain Medicine (Anesthesiology) Physician
- Aurora, IL
- NPI 1952308223
-
- Interventional Pain Medicine Physician
- Aurora, IL
- NPI 1326097221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1689676694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6910 S MADISON ST",
"city": "WILLOW BROOK",
"state": "IL",
"postal_code": "605275504",
"telephone_number": "815-748-8993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 BETHANY RD",
"city": "DEKALB",
"state": "IL",
"postal_code": "601154939",
"telephone_number": "815-748-8993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLOUD",
"first_name": "CRAIG",
"middle_name": "R",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "IL",
"license": null,
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.