Individual provider Active NPI

Pauline Schultz, CRNA

  • Certified Registered Nurse Anesthetist
  • Flossmoor, IL
National Provider Identifier
1891797312
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209003700 Issued in IL
Practice address
19624 Governors Hwy
Flossmoor, IL 60422-2077
Phone
(708) 798-5838
Fax
(708) 798-5865
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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 209003700 IL Primary

Addresses

Primary practice location

19624 Governors Hwy
Flossmoor, IL 60422-2077

Mailing address

19624 Governors Hwy
Flossmoor, IL 60422-2077
Phone (708) 798-5838

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040730000503 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557331006 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
George N Atia MD SCGroup PAC ID 2961506670, 12 clinicians

Practice addresses (Care Compare)

200 Fox Glen CT
Barrington, IL 60010-1809
Phone (847) 382-7165

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-3000

5744 N Broadway St
Chicago, IL 60660-4302
Phone (312) 335-0180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209003700ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Dec 11, 2011 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Illinois Gastroenterology Group, LLC CurrentSince Apr 15, 2022 Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
George N Atia, M.D., S.C. CurrentSince Oct 1, 2019 Accepting new patients

Locations

200 Fox Gln
Barrington, IL 60010
Phone (847) 382-7165

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

5744 N Broadway St
Ste 2
Chicago, IL 60660

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

19624 Governors Hwy
Flossmoor, IL 60422
Phone (708) 752-5306

17901 Governors Hwy
Ste 106
Homewood, IL 60430
Phone (708) 799-3305

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

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1891797312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222077",
            "telephone_number": "708-798-5838",
            "fax_number": "708-798-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222077",
            "telephone_number": "708-798-5838",
            "fax_number": "708-798-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "PAULINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209003700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.