Scott A Waggoner, CRNA | |
2202 Harlem Rd, Loves Park, IL 61111-2754 | |
(815) 877-4848 | |
(815) 636-6125 |
Full Name | Scott A Waggoner |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 10 Years |
Location | 2202 Harlem Rd, Loves Park, 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 |
---|---|---|---|
1336545854 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 209.012327 (Illinois) | Primary |
163W00000X | Registered Nurse | 041.425396 (Illinois) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Presence Saint Francis Hospital | Evanston, IL | Hospital |
Presence Saints Mary And Elizabeth Medical Center | Chicago, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Northstar Anesthesia Of Illinois, Llc | 4688893878 | 213 |
Rockford Anesthesiologists Associated Llc | 5597668004 | 51 |
Entity Name | Rockford Anesthesiologists Associated Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629090642 PECOS PAC ID: 5597668004 Enrollment ID: O20040517001037 |
Entity Name | Northstar Anesthesia Of Illinois, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962822395 PECOS PAC ID: 4688893878 Enrollment ID: O20140922000405 |
Mailing Address | Practice Location Address |
---|---|
Scott A Waggoner, CRNA 2202 Harlem Rd, Loves Park, IL 61111-2754 Ph: (815) 877-4848 | Scott A Waggoner, CRNA 2202 Harlem Rd, Loves Park, IL 61111-2754 Ph: (815) 877-4848 |
Kathleen M. Schroeder, C.R.N.A. Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2202 Harlem Rd, Loves Park, IL 61111 Phone: 815-877-4848 Fax: 815-654-5342 | |
Mr. Lowell S. Wills, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2202 Harlem Road, Suite 200, Loves Park, IL 61111 Phone: 815-877-4848 Fax: 815-636-6125 | |
Ronald J. Frenk, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2202 Harlem Rd, Loves Park, IL 61111 Phone: 815-877-4848 Fax: 815-654-5342 | |
Malynnda A. Mueller, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2202 Harlem Rd, Loves Park, IL 61111 Phone: 815-877-4848 Fax: 815-654-5342 | |
Justin Erik Utley, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2202 Harlem Rd, Loves Park, IL 61111 Phone: 815-877-4848 Fax: 815-636-6125 | |
Paula M. Dobrowolska, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2202 Harlem Rd, Suite 200, Loves Park, IL 61111 Phone: 815-877-4848 Fax: 815-654-5342 |