| Jacob R Paul, CRNA | |
|
200 Fox Glen Ct, Barrington, IL 60010-1809 | |
| (847) 382-7165 | |
| (847) 713-8160 |
| Full Name | Jacob R Paul |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 200 Fox Glen Ct, Barrington, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780022871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 163723 (Wisconsin) | Primary |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Entity Name | The Medical College Of Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
| Entity Name | Anesthesia Partners Services Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861810947 PECOS PAC ID: 4082832514 Enrollment ID: O20140826000757 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob R Paul, CRNA 4025 N 92nd St, Wauwatosa, WI 53222-1613 Ph: (414) 358-5431 | Jacob R Paul, CRNA 200 Fox Glen Ct, Barrington, IL 60010-1809 Ph: (847) 382-7165 |
Susan Podlogar, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 200 Fox Glen Ct, Barrington, IL 60010 Phone: 847-382-7165 Fax: 847-713-8160 |