Individual provider Active NPI

Richard G Janicki, CRNA

  • Certified Registered Nurse Anesthetist
  • Oak Lawn, IL
National Provider Identifier
1942472410
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209007374 Issued in IL
Practice address
10500 S Cicero Ave
Oak Lawn, IL 60453-5205
Phone
(708) 424-1202
NPI assigned
Mar 25, 2008
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 041-302333 IL
Certified Registered Nurse Anesthetist 367500000X 209007374 IL Primary

Addresses

Primary practice location

10500 S Cicero Ave
Oak Lawn, IL 60453-5205

Mailing address

18221 Torrence Ave
Lansing, IL 60438-2870
Phone (708) 895-9450

Other practice location 1

18221 Torrence Ave
Lansing, IL 60438-2870
Phone (708) 895-9450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041-302333ILMDRegistered Nurse
209007374ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Illinois, LLC Past Accepting new patients
Interventional Pain Management, LTD. Past Accepting new patients
Anesthesia Associates, LTD Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942472410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18221 TORRENCE AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604382870",
            "telephone_number": "708-895-9450",
            "fax_number": "708-895-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535205",
            "telephone_number": "708-424-1202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18221 Torrence Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "IL",
            "postal_code": "604382870",
            "country_code": "US",
            "telephone_number": "708-895-9450",
            "fax_number": "708-895-9455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANICKI",
        "first_name": "RICHARD",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-302333",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209007374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.