Individual provider Active NPI

Jessica M Kunkel

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1982269379
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.019058 Issued in IL
Practice address
2233 W Division St
Chicago, IL 60622-8151
Phone
(312) 770-2000
NPI assigned
May 1, 2019
Last updated
May 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2019

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 209.019058 IL Primary

Addresses

Primary practice location

2233 W Division St
Chicago, IL 60622-8151

Mailing address

2438 W Huron St
Chicago, IL 60612-1208
Phone (630) 251-4797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190520002191 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961745609 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rush Medical College of Rush University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates, LTDGroup PAC ID 2961303425, 34 clinicians

Practice addresses (Care Compare)

600 E 1St St
Spring Valley, IL 61362-1512
Phone (815) 664-5311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.019058ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Elmhurst Anesthesiologists, PC CurrentSince Mar 25, 2022 Accepting new patients
Anesthesia Associates, LTD CurrentSince Feb 1, 2022 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince May 13, 2019 Accepting new patients

Locations

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

1200 S York St
Elmhurst, IL 60126
Phone (331) 221-5678

155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

600 E 1st St
Spring Valley, IL 61362
Phone (815) 664-1477

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.

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1982269379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2438 W HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121208",
            "telephone_number": "630-251-4797"
        },
        {
            "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": "312-770-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "JESSICA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.019058",
            "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 May 1, 2019; 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.