NPIMap

Organization Active NPI

Advantage Anesthesia P.C.

  • Anesthesiology Physician
  • Libertyville, IL
National Provider Identifier
1700434149
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ADVANTAGE ANESTHESIA P.C.
Doing business as
Advantage Anesthesia P.C.
Practice address
1105 W Park Ave Ste 1
Libertyville, IL 60048-2567
Phone
(331) 575-6121
NPI assigned
Aug 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lynn M Ulrich, NURSE ANESTHESIOLOGYNPI 1124065925
Title
President
Phone
(331) 575-6121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1105 W Park Ave Ste 1
Libertyville, IL 60048-2567

Mailing address

1056 Suffolk CT
Gurnee, IL 60031-5605
Phone (331) 575-6121

Other names 1

  • Advantage Anesthesia P.C. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191015001128 IL Part B Supplier - Clinic/Group Practice 3476884966 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Barrington, IL; Libertyville, IL

National Provider Directory

National Provider Directory

Locations

22285 N Pepper Rd
Ste 303
Lake Barrington, IL 60010
Phone (847) 842-0757

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1700434149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 SUFFOLK CT",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315605",
            "telephone_number": "331-575-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W PARK AVE STE 1",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482567",
            "telephone_number": "331-575-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE ANESTHESIA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "ULRICH",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "331-575-6121",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE ANESTHESIOLOGY"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Anesthesia P.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advantage Anesthesia P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 26, 2019; 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.