Ebonee Monique Blake, - Medicare Nurse Anesthetist, Certified Registered in Maywood, IL

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Ebonee Monique Blake, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Maywood, Illinois. Her current practice location is 2160 S 1st Ave, Maywood, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 216-9000.

Ebonee Monique Blake is licensed to practice in Illinois (license number 209025731) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083356745.

Contact Information

Ebonee Monique Blake,
2160 S 1st Ave,
Maywood, IL 60153-3328
(708) 216-9000
Not Available

Map and Direction




Provider's Profile

Full NameEbonee Monique Blake
GenderFemale
SpecialityNurse Anesthetist, Certified Registered
Location2160 S 1st Ave, Maywood, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1083356745
  • Provider Enumeration Date: 04/12/2022
  • Last Update Date: 09/08/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9537535042
  • Enrollment ID: I20221024001923

Medical Identifiers

Medical identifiers for Ebonee Monique Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083356745NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 209025731 (Illinois)Primary
163W00000XRegistered Nurse 041422578 (Illinois)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ebonee Monique Blake allows following entities to bill medicare on her behalf.
Entity NameAdvocate Health And Hospitals Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700824455
PECOS PAC ID: 7810800935
Enrollment ID: O20031106000064
Entity NameLoyola University Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336159961
PECOS PAC ID: 3779488903
Enrollment ID: O20031202000027
Entity NameUniversity Anesthesiologists Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073558136
PECOS PAC ID: 4183512080
Enrollment ID: O20040415000513

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ebonee Monique Blake is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ebonee Monique Blake,
443 N Laverne Ave,
Hillside, IL 60162-1223

Ph: (708) 769-2519		Ebonee Monique Blake,
2160 S 1st Ave,
Maywood, IL 60153-3328

Ph: (708) 216-9000

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Maywood, IL

Joseph Marinaro, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-8785    
Mark Byram,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-9000    
Laura Hartman,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 847-347-9847    
Joshua Mitchell,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-3619    
Joy Malenie Chaksupa, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-5856    
Luis Enrique Negron, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 888-584-7888    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.