DR. BRIAN WADE MECKLENBURG (NPI# 1912047085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912047085 |
| Entity Type | Individual |
| Full Name | DR. BRIAN WADE MECKLENBURG |
| Credential | M.D. |
| Practice Address |
2202 Harlem Road Suite 200 Loves Park IL 61111-2754 |
| Practice Telephone | 8158774848 |
| Practice Fax Number | 8156543271 |
| Mailing Telephone | 8158774848 |
| Mailing Fax Number | 8156543271 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 036.149788 | IL | Allopathic & Osteopathic Physicians |
| N | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
0101102755 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036149788 | 05 |
| Street Address |
2202 HARLEM ROAD SUITE 200 |
| City | LOVES PARK |
| State | IL |
| Zip Code | 61111-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982609343 | Jane A. Rickman | Registered Nurse | 2202 Harlem Road, Suite 200, Loves Park, IL 61111-2754 | 2005-06-14 |
| 1932527132 | Paola Pesantes | Anesthesiology | 2202 Harlem Road, Suite 200, Loves Park, IL 61111 | 2014-04-03 |
| 1063842102 | Nathaniel Schwartz | Registered Nurse | 2202 Harlem Road, Suite 200, Loves Park, IL 61111-2754 | 2013-11-26 |
| 1609205806 | Kelsey A. Wiechen | Nurse Anesthetist, Certified Registered | 2202 Harlem Road, Suite 200, Loves Park, IL 61111-2754 | 2013-11-07 |
| 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 |
| 1255502423 | Stephanie Marie Dulian | Registered Nurse | 2202 Harlem Road, Loves Park, IL 61111-2754 | 2008-03-17 |
| 1013188598 | Wieslaw J. Podlasek | Anesthesiology | 2202 Harlem Road, Loves Park, IL 61111-2754 | 2008-03-12 |
| 1598975260 | Kyle Edward Wilhite | Anesthesiology | 2202 Harlem Road, Suite 200, Loves Park, IL 61111 | 2007-05-23 |
| 1760559207 | Nicole Soraya Nouwairi | Nurse Anesthetist, Certified Registered | 2202 Harlem Road, Loves Park, IL 61111-2754 | 2006-11-29 |
| Find all providers in the same location | ||||
| 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 | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083906382 | Gagandeep Goyal | Anesthesiology | 5504 N 2nd St, Loves Park, IL 61111 | 2011-05-05 |
| 1639128598 | Rockford Anesthesiologists Associated, L.L.C. | Anesthesiology | 2202 Harlem Rd, Loves Park, IL 61111-2754 | 2006-05-09 |
| 1932527132 | Paola Pesantes | Anesthesiology | 2202 Harlem Road, Suite 200, Loves Park, IL 61111 | 2014-04-03 |
| 1962718114 | Stanislav Brandis | Anesthesiology | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2010-08-25 |
| 1093940611 | Lenney G. Kizhakepunnur | Anesthesiology | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2009-05-27 |
| 1114182698 | Lisa P Solomon | Anesthesiology | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2008-07-23 |
| 1124283114 | Nathan J Hahn | Anesthesiology | 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 2008-07-19 |
| 1114187705 | Molly Mae Kelly | Anesthesiology | 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 | 2008-06-17 |
| 1013188598 | Wieslaw J. Podlasek | Anesthesiology | 2202 Harlem Road, Loves Park, IL 61111-2754 | 2008-03-12 |
| 1598975260 | Kyle Edward Wilhite | Anesthesiology | 2202 Harlem Road, Suite 200, Loves Park, IL 61111 | 2007-05-23 |
| Find all providers in LOVES PARK | ||||
| City | LOVES PARK |
| Zip Code | 61111 |
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| 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.