NPIMap

Organization Active NPI

Anesthesia Assoc of Northeast Illinois

  • Anesthesiology Physician
  • Tinley Park, IL
National Provider Identifier
1992795892
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA ASSOC OF NORTHEAST ILLINOIS
Practice address
6701 159TH St
Ingalls Same Day Surgery
Tinley Park, IL 60477-1758
Phone
(708) 915-7318
Fax
(708) 429-0220
NPI assigned
Oct 24, 2005
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Frank J Kniffen, M.D.NPI 1124027651
Title
President
Phone
(708) 915-7318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

6701 159TH St
Ingalls Same Day Surgery
Tinley Park, IL 60477-1758

Mailing address

PO Box 100
Matteson, IL 60443-0100
Phone (708) 747-5850

Other identifiers 1

IdentifierTypeStateIssuer
0161887464OtherBCBSIL GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

25 E Washington St
Fl Third
Chicago, IL 60602
Phone (708) 747-1357

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1992795892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430100",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 159TH ST",
            "address_2": "INGALLS SAME DAY SURGERY",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771758",
            "telephone_number": "708-915-7318",
            "fax_number": "708-429-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA ASSOC OF NORTHEAST ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "KNIFFEN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-915-7318",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP NUMBER",
            "identifier": "0161887464",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.