Individual provider Active NPI

Jenna Leigh O'Brien, RN

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1710665674
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209030931 Issued in IL
Practice address
3109 N Karlov Ave
Chicago, IL 60641-5436
Phone
(614) 746-7020
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041480863 IL
Certified Registered Nurse Anesthetist 367500000X 209030931 IL Primary

Addresses

Primary practice location

3109 N Karlov Ave
Chicago, IL 60641-5436

Mailing address

3109 N Karlov Ave
Chicago, IL 60641-5436
Phone (614) 746-7020

Other names 1

  • Miss Jenna Leigh Winzenread Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120003112 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860927357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3231 Euclid Ave
FL 5
Berwyn, IL 60402-4603
Phone (708) 783-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041480863ILMDRegistered Nurse
209030931ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gottlieb Community Health Services Corporation CurrentSince Oct 14, 2024 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Oct 14, 2024 Accepting new patients

Locations

3231 Euclid Ave
Fl 5
Berwyn, IL 60402
Phone (708) 783-2000

3231 Euclid Ave
Berwyn, IL 60402
Phone (708) 783-2407

125 N La Grange Rd
La Grange, IL 60525
Phone (708) 354-4900

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1710665674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 N KARLOV AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606415436",
            "telephone_number": "614-746-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 N KARLOV AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606415436",
            "telephone_number": "614-746-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JENNA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041480863",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209030931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "WINZENREAD",
            "middle_name": "LEIGH",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.

Verify at the official NPI Registry.