| Mr Derek J Humphres, CRNA | |
|
6742 N Frostwood Pkwy, Peoria, IL 61615-2402 | |
| (309) 692-5393 | |
| (309) 683-9998 |
| Full Name | Mr Derek J Humphres |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 3 Years |
| Location | 6742 N Frostwood Pkwy, Peoria, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942981766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209025607 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Associated Anesthesiologists Sc | 6305744129 | 119 |
| Entity Name | Associated Anesthesiologists Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558306480 PECOS PAC ID: 6305744129 Enrollment ID: O20031230000544 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Derek J Humphres, CRNA 128 Justice Dr, East Peoria, IL 61611-1468 Ph: (309) 369-1543 | Mr Derek J Humphres, CRNA 6742 N Frostwood Pkwy, Peoria, IL 61615-2402 Ph: (309) 692-5393 |
Melissa Terhark, C.R.N.A Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 8600 North State Route 91, Suite #250, Peoria, IL 61615 Phone: 309-692-5394 Fax: 309-692-2538 | |
Bradley Alan Kirkenir, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7309 N Knoxville Ave, Peoria, IL 61614 Phone: 217-528-7541 | |
Sandra M Krahn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5522 | |
Adam Randel Osborne, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5550 | |
Mr. Kip Neuhoff, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6742 N Frostwood Pkwy, Peoria, IL 61615 Phone: 309-655-4809 | |
Dr. Samantha Mae Aufderhaar, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000 | |
Mr. Gary L Boniger, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 8600 N State Route 91, Suite 250, Peoria, IL 61615 Phone: 309-692-5393 Fax: 309-692-2538 |