| Michael Agnich, CRNA | |
|
1210 Crown Fox Ln, New Lenox, IL 60451-1205 | |
| (815) 320-3086 | |
| (815) 464-1767 |
| Full Name | Michael Agnich |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1210 Crown Fox Ln, New Lenox, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922010933 | NPI | - | NPPES |
| 9932061 | Other | IL | BLUE CROSS BLUE SHIELD |
| 430075461 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 209-000590 (Illinois) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 209000590 (Illinois) | Primary |
| Entity Name | Anesthesia Advocates, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790797710 PECOS PAC ID: 3476529249 Enrollment ID: O20040903000164 |
| Entity Name | North American Partners In Anesthesia Illinois Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699032524 PECOS PAC ID: 1052576519 Enrollment ID: O20120706000534 |
| Entity Name | Midwest Anesthesia Providers Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295189082 PECOS PAC ID: 9830480581 Enrollment ID: O20160628000182 |
| Entity Name | Elite Anesthesia Providers Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679258388 PECOS PAC ID: 6709249006 Enrollment ID: O20230905001966 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Agnich, CRNA Po Box 367, Frankfort, IL 60423-0367 Ph: (815) 320-3086 | Michael Agnich, CRNA 1210 Crown Fox Ln, New Lenox, IL 60451-1205 Ph: (815) 320-3086 |