Individual provider Active NPI

Tracy H. Vanderwiel, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1871526749
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209006628 Issued in IL
Practice address
251 E Huron St Ste 5-704
Chicago, IL 60611-2908
Phone
(312) 926-8369
Fax
(312) 926-8341
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209006628 IL Primary
Registered Nurse 163W00000X 041-316353 IL

Addresses

Primary practice location

251 E Huron St Ste 5-704
Chicago, IL 60611-2908

Mailing address

251 E Huron St Ste 5-704
Chicago, IL 60611-2908
Phone (312) 926-8369

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000028 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557453115 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4060

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 352-5450

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041-316353ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 31, 2022 Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 31, 2022 Accepting new patients
Kane Anesthesia Associates, SC CurrentSince Aug 8, 2012 Accepting new patients
Illinois Gastroenterology Group, LLC CurrentSince Mar 1, 2018 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Delnor Community Hospital Past Accepting new patients
Central Dupage Physician Group PastSince Dec 18, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Ste 5704
Chicago, IL 60611
Phone (312) 695-0061

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

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

304 Randall Rd
Geneva, IL 60134
Phone (630) 232-0610

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

Organizations & group practices 9

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 3

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1871526749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-8369",
            "fax_number": "312-926-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-8369",
            "fax_number": "312-926-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWIEL",
        "first_name": "TRACY",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209006628",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-316353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 14, 2022; 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.