Active NPI
Bermon Wren Reyes Punzalan, APRN, CRNA
- Certified Registered Nurse Anesthetist
- McHenry, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209033305
- Practice address
- 4201 W Medical Center Dr
McHenry, IL 60050-8409 - Phone
- (815) 344-5000
- Fax
- (815) 344-3347
- NPI assigned
- Jun 26, 2025
- Last updated
- Feb 6, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 95002704 | CA | |
| Certified Registered Nurse Anesthetist | 367500000X | 209033305 | IL | Primary |
| Registered Nurse | 163W00000X | 95196322 | CA |
Addresses
Primary practice location
4201 W Medical Center Dr
McHenry, IL 60050-8409
Mailing address
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, IL
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone (213) 413-3000
1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 742-5910
18575 Gale Ave
Suite 198
City of Industry, CA 91748-1382
Phone (626) 965-3880
4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070
515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95196322 | CA | MD | Registered Nurse |
| 209033305 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Socal Anesthesia Solutions, Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Credence Anesthesia Corporation | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| HP Anesthesia Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| West Coast Surgery Inc | Past | Accepting new patients |
Locations
1000 S Anaheim Blvd
Ste 300
Anaheim, CA 92805
Phone (714) 221-2196
18575 Gale Ave
Ste 198
City of Industry, CA 91748
Phone (626) 656-1285
12017 Paramount Blvd
Downey, CA 90242
Phone (562) 381-2494
1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000
1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555
2000 Outlet Center Dr
Oxnard, CA 93036
Phone (805) 643-3332
36915 Cook St
Ste 103B
Palm Desert, CA 92211
Phone (760) 340-1003
815 Auto Center Dr
Palmdale, CA 93551
Phone (661) 206-6262
7640 Tampa Ave
Ste 102
Reseda, CA 91335
Phone (818) 674-4888
5651 Sepulveda Blvd
Ste 101
Van Nuys, CA 91411
Phone (818) 442-9696
Dept 5777
Carol Stream, IL 60122
660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Certified Registered Nurse Anesthetist
- Oxnard, CA
- NPI 1881381002
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Los Angeles, CA
- NPI 1992133474
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Los Angeles, CA
- NPI 1407596901
Nurse Anesthetist, Certified Registered
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
- Orthopaedic Surgery Physician
- Palm Desert, CA
- NPI 1992248918
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Centegra Hospital McHenry
- General Acute Care Hospital
- McHenry, IL
- NPI 1982611281
-
dba Hollywood Presbyterian Medical Center
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1922033547
-
dba California Hospital Medical Center - Los Angeles
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1114081056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770336000000",
"number": "1700774734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 W MEDICAL CENTER DR",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508409",
"telephone_number": "815-344-5000",
"fax_number": "815-344-3347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 W MEDICAL CENTER DR",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508409",
"telephone_number": "815-344-5000",
"fax_number": "815-344-3347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUNZALAN",
"first_name": "BERMON WREN",
"middle_name": "REYES",
"credential": "APRN, CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-26",
"last_updated": "2026-02-06",
"certification_date": "2026-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95002704",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209033305",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95196322",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McHenry, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.