NPIMap

Organization Active NPI

Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
National Provider Identifier
1962822395
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTHSTAR ANESTHESIA OF ILLINOIS, LLC
Practice address
2000 E Lamar Blvd Ste 400
Arlington, TX 76006-7353
Phone
(817) 583-7421
NPI assigned
Apr 24, 2014
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Phil Eichenholz, MD
Title
President
Phone
(817) 583-7421

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

2000 E Lamar Blvd Ste 400
Arlington, TX 76006-7353

Mailing address

PO Box 612485
Dallas, TX 75261-2485
Phone (239) 610-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140922000405 IL Part B Supplier - Clinic/Group Practice 4688893878 Receives reassigned benefits from 722 practitioners
Practice locations: Olympia Fields, IL; Aurora, IL; Oak Lawn, IL; Murphysboro, IL; Mount Vernon, IL; La Grange, IL; Hoffman Estates, IL; Hinsdale, IL…

National Provider Directory

National Provider Directory

Locations

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994

Practitioners & affiliated clinicians

Practitioners 728

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.

View all 728

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1962822395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612485",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752612485",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAMAR BLVD STE 400",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760067353",
            "telephone_number": "817-583-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR ANESTHESIA OF ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "EICHENHOLZ",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-583-7421",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.