Individual provider Active NPI

Jane Fanslow, CRNA

  • Certified Registered Nurse Anesthetist
  • Aurora, IL
National Provider Identifier
1730137894
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Practice address
Provena Mercy Medical Center
1325 N. Highland Avenue
Aurora, IL 60506
Phone
(630) 859-2222
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X IL Primary

Addresses

Primary practice location

Provena Mercy Medical Center
1325 N. Highland Avenue
Aurora, IL 60506

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001511 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709874035 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apollo Medical Group of Illinois LLCGroup PAC ID 4880036078, 22 clinicians

Practice addresses (Care Compare)

2475 Dean St
St Charles, IL 60175-4831
Phone (630) 584-9800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209004012ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kane Anesthesia Associates, SC CurrentSince Jun 30, 2008 Accepting new patients
Apollo Medical Group of Illinois LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 2, 2025 Accepting new patients
Valley Ambulatory Surgery Center Anesthesiology LTD CurrentSince Oct 1, 2016 Accepting new patients
Valley Ambulatory Surgery Center, LP Current Accepting new patients
Atp Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Gottlieb Midwest Anesthesiologists, LLC Past Accepting new patients

Locations

34536 Eagle Way
Chicago, IL 60678

3034 W Peterson Ave
Chicago, IL 60659
Phone (773) 973-7432

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

2475 Dean St
St Charles, IL 60175
Phone (630) 584-9800

2210 Dean St
St Charles, IL 60175
Phone (630) 443-3397

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730137894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PROVENA MERCY MEDICAL CENTER",
            "address_2": "1325 N. HIGHLAND AVENUE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60506",
            "telephone_number": "630-859-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANSLOW",
        "first_name": "JANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, 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.

Verify at the official NPI Registry.