Illinois Anesthesia Coverage P.C.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209 001163 Issued in IL

Legal business name

ILLINOIS ANESTHESIA COVERAGE P.C.

Practice address

4010 Riverknoll Dr
Champaign, IL 61822-9213

Phone

(217) 352-8947

Fax

(217) 352-8947

NPI assigned

Mar 5, 2007

Last updated

Mar 31, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jerome William Wellinghoff, CRNANPI 1326020264

Title

President

Phone

(217) 352-8947

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerome W. Wellinghoff, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Champaign, IL
  • NPI 1326020264
  Authorized official Same address or phone
• Thomas Royce Silbernagel, CRNA

  • Certified Registered Nurse Anesthetist
  • Neillsville, WI
  • NPI 1922097351

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1750410726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7048",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618267048",
            "telephone_number": "217-352-8947",
            "fax_number": "217-352-8947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 RIVERKNOLL DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618229213",
            "telephone_number": "217-352-8947",
            "fax_number": "217-352-8947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS ANESTHESIA COVERAGE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "WELLINGHOFF",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-352-8947",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209 001163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, RAILROAD",
            "identifier": "CG3273",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE MILITARY",
            "identifier": "A001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "092-253-24",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Illini Eyecare Inc-Champaign
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• Illini Open MRI, LLC
• Illini Smiles Dental Care PC
• Illini Smiles Dental Care PC
• Illinois Endodontics, LLC
• Illinois Spine and Pain Center SC
• Improving Smiles LTD (Champaign Dental Care)
• Independence Holding Co LLC (complete care pharmacy champaign)
• Independence Holding Co LLC (Complete Care Pharmacy)

• Certified Registered Nurse Anesthetist in Champaign, IL
• Providers in Champaign, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.