| Kyle Mieszcak, | |
|
3249 Oak Park Ave, Berwyn, IL 60402-3429 | |
| (708) 783-2226 | |
| Not Available |
| Full Name | Kyle Mieszcak |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 3249 Oak Park Ave, Berwyn, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417624206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209027850 (Illinois) | Primary |
| Entity Name | Gottlieb Community Health Services Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013415603 PECOS PAC ID: 3375442999 Enrollment ID: O20180420000980 |
| Entity Name | Loyola Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376041954 PECOS PAC ID: 6305109547 Enrollment ID: O20180420002063 |
| Entity Name | Encore Anesthesia Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558987883 PECOS PAC ID: 3476979683 Enrollment ID: O20200819000850 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Mieszcak, 336 Mission Ave, Villa Park, IL 60181-1903 Ph: (630) 986-7648 | Kyle Mieszcak, 3249 Oak Park Ave, Berwyn, IL 60402-3429 Ph: (708) 783-2226 |
Telma Karerakattil, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-785-3545 | |
Stanley Ansel Kristiansen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-3013 | |
Jessica Hubl, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 773-818-1132 | |
Tita J Jacildo, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3249 Oak Park Ave, Anesthesia Department, Berwyn, IL 60402 Phone: 708-783-3667 | |
Elma Divinagracia, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3249 Oak Park Ave, Anesthesia Department, Berwyn, IL 60402 Phone: 708-783-3667 | |
Yoojung Kang, MSN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-2226 | |
Michelle Akan, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-9100 |