Individual provider Active NPI

Daniel Connolly, CRNA

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1972933372
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.010854 Issued in IL
Practice address
2233 W Division St
Chicago, IL 60622-8151
Phone
(312) 770-2172
NPI assigned
Nov 21, 2013
Last updated
Jul 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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 209.010854 IL Primary

Addresses

Primary practice location

2233 W Division St
Chicago, IL 60622-8151

Mailing address

8378 Dunmore Dr
Tinley Park, IL 60487-4496
Phone (630) 254-9624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131212001712 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648407999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vigilance Anesthesiologists and Pain Specialists PCGroup PAC ID 4284975541, 6 clinicians

Practice addresses (Care Compare)

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.010854ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jun 9, 2021 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jun 9, 2021 Accepting new patients

Locations

7447 W Talcott Ave
Ste 451
Chicago, IL 60631
Phone (773) 763-3990

21120 Washington Pkwy
Frankfort, IL 60423
Phone (815) 462-8470

1541 Riverboat Center Dr
Joliet, IL 60431
Phone (815) 409-4700

5851 W 95th St
Oak Lawn, IL 60453
Phone (708) 574-6143

10401 S Roberts Rd
Ste 2
Palos Hills, IL 60465
Phone (708) 430-1600

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1972933372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8378 DUNMORE DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604874496",
            "telephone_number": "630-254-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228151",
            "telephone_number": "312-770-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "DANIEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-21",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.010854",
            "primary": true
        }
    ],
    "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 Jul 26, 2016; 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.