ETHAN S HARRIS (NPI# 1629638788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629638788 |
| Entity Type | Individual |
| Full Name | ETHAN S HARRIS |
| Credential | CRNA |
| Practice Address |
2202 Harlem Rd Ste 200 Loves Park IL 61111-2754 |
| Practice Telephone | 8158774848 |
| Practice Fax Number | 8156366125 |
| Mailing Telephone | 8158774848 |
| Mailing Fax Number | 8156366125 |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 209019805 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255451266 | Ethan Daniel Harris | Dentist | 2301 Camino Ramon Ste 294, San Ramon, CA 94583-4440 | 2007-03-31 |
| 1730230038 | Ethan G. Harris | Social Worker | 240 Merriam St, Weston, MA 02493-1348 | 2007-01-15 |
| 1124011689 | Ethan Geoffrey Harris | Psychiatry & Neurology | 720 Howe Ave, Suite 110, Sacramento, CA 95825-4669 | 2005-08-30 |
| 1881188563 | Ethan Daniel Harris | Military Health Care Provider | 200 Mercy Cir, Camp Pendleton, CA 92055 | 2018-06-18 |
| 1205344660 | Ethan A Harris | Pharmacist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2018-01-18 |
| Street Address |
2202 HARLEM RD STE 200 |
| City | LOVES PARK |
| State | IL |
| Zip Code | 61111-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568424505 | Ali S. Nouwairi | Registered Nurse | 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 | 2006-04-05 |
| 1992228365 | Becky L Madsen | Registered Nurse | 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 | 2017-07-18 |
| 1114187705 | Molly Mae Kelly | Anesthesiology | 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 | 2008-06-17 |
| 1275607632 | Marie P Richter | Anesthesiology | 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 | 2006-11-20 |
| 1902818792 | Jody A. Frazier | Registered Nurse | 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316562788 | Salli Jacobsen | Technician | 6699 Torch Lite Tr, Loves Park, IL 61111 | 2020-06-11 |
| 1003476425 | Costco Wholesale Corporation | Pharmacy | 5000 Stadium Drive, Loves Park, IL 61111 | 2019-06-18 |
| 1427541077 | Ronit Golan | Physical Therapist | 4401 Peak Dr Ste 1, Loves Park, IL 61111 | 2018-06-08 |
| 1598049025 | Sara Debelak | Developmental Therapist | 7225 Golden Eagle Drive, Loves Park, IL 61111 | 2011-10-03 |
| 1083906382 | Gagandeep Goyal | Anesthesiology | 5504 N 2nd St, Loves Park, IL 61111 | 2011-05-05 |
| 1124354261 | Asap Transport, LLC | Taxi | 7117 Clinton Rd, Suite 4, Loves Park, IL 61111 | 2009-10-25 |
| 1235212275 | Roger H Hill | Optometrist | 4301 N Mulford Rd, Loves Park, IL 61111 | 2006-10-23 |
| 1831104546 | Pointcore, Inc. | Pharmacy | 9951 Rock Cut Crossing, Loves Park, IL 61111 | 2006-07-30 |
| 1629099627 | Lisa A. Breisch | Counselor | Harmony Center for Holistic Psychotherapy, 6625 N. 2nd Street, Loves Park, IL 61111 | 2006-07-22 |
| 1386670529 | Joseph L Digirolamo | Chiropractor | 116 East Riverside Blvd, Loves Park, IL 61111 | 2006-06-22 |
| Find all providers in zip 61111 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417353319 | Paula M. Dobrowolska | Nurse Anesthetist, Certified Registered | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2014-11-05 |
| 1609205806 | Kelsey A. Wiechen | Nurse Anesthetist, Certified Registered | 2202 Harlem Road, Suite 200, Loves Park, IL 61111-2754 | 2013-11-07 |
| 1447683271 | Todd R. Smidt | Nurse Anesthetist, Certified Registered | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2013-08-15 |
| 1528336971 | Michael V. Atendido | Nurse Anesthetist, Certified Registered | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2011-12-13 |
| 1811121254 | Darcy J Myers | Nurse Anesthetist, Certified Registered | 2202 Harlem Road, Suite 200, Loves Park, IL 61111-2754 | 2009-05-13 |
| 1770735052 | Samuel Taylor Schwegler | Nurse Anesthetist, Certified Registered | 2202 Harlem Road, Loves Park, IL 61111-2754 | 2008-10-17 |
| 1245402965 | Rock Valley Advanced Pain Management Inc. | Nurse Anesthetist, Certified Registered | 6550 E Riverside Blvd, Loves Park, IL 61111-4424 | 2008-04-02 |
| 1851572267 | Elizabeth Diane Loudermilk | Nurse Anesthetist, Certified Registered | 2202 Harlem Rd, Loves Park, IL 61111-2754 | 2007-11-14 |
| 1760559207 | Nicole Soraya Nouwairi | Nurse Anesthetist, Certified Registered | 2202 Harlem Road, Loves Park, IL 61111-2754 | 2006-11-29 |
| 1275628588 | Malynnda A. Mueller | Nurse Anesthetist, Certified Registered | 2202 Harlem Rd, Loves Park, IL 61111-2754 | 2006-10-03 |
| Find all providers in LOVES PARK | ||||
| City | LOVES PARK |
| Zip Code | 61111 |
Please comment or provide details below to improve the information on ETHAN S HARRIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.