Provider Demographics
NPI:1225044043
Name:ASPEN ANESTHESIA, PC
Entity Type:Organization
Organization Name:ASPEN ANESTHESIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:F
Authorized Official - Last Name:SNUKST
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:630-472-8822
Mailing Address - Street 1:PO BOX 4781
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-4781
Mailing Address - Country:US
Mailing Address - Phone:630-472-8822
Mailing Address - Fax:630-472-8824
Practice Address - Street 1:22285 N PEPPER RD
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2538
Practice Address - Country:US
Practice Address - Phone:630-472-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2226914OtherBC/BS PROVIDER #
IL2226914OtherBC/BS PROVIDER #
IL578340Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
IL549400Medicare PIN