Dimitri Bagrov (NPI# 1205285855, PAC ID# 3971890799) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1205285855 |
| PAC ID by PECOS | 3971890799 |
| Professional Enrollment ID | I20160922000996 |
| Full Name | Dimitri Bagrov |
| Organization Legal Name | LIBERTY ANESTHESIA SERVICES LLC |
| Address |
1870 W Winchester Rd Suite 146 Libertyville IL 60048-5359 |
| Phone Number | 2244336505 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 5698059517 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140290 | ST ALEXIUS MEDICAL CENTER |
| 140258 | ALEXIAN BROTHERS MEDICAL CENTER 1 |
| Address | Phone | Organization |
|---|---|---|
| 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 7736653000 | MIDWEST ANESTHESIA PARTNERS LLC |
| 1555 Barrington Rd, Hoffman Estate, IL 60169-1019 | 8478432000 | MIDWEST ANESTHESIA PARTNERS LLC |
| 1555 Barrington Rd, Suite 400, Hoffman Estates, IL 60169-5040 | 8475191600 | MIDWEST ANESTHESIA PARTNERS LLC |
| 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 | 2244336505 | LIBERTY ANESTHESIA SERVICES LLC |
| Organization Legal Name | LIBERTY ANESTHESIA SERVICES LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katherin M Aoki | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Chanda L Von Heimburg | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Lois A Barnes | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Krzysztof P Malewicz | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Ebele Okonkwor | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Karen S Filipowski | Certified Registered Nurse Anesthetist | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Street Address |
1870 W WINCHESTER RD SUITE 146 |
| City | LIBERTYVILLE |
| State | IL |
| Zip | 60048-5359 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William A Martinez | Family Medicine | 1870 W Winchester Rd, Suite 145, Libertyville, IL 60048-5359 | |
| Katherin M Aoki | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Chanda L Von Heimburg | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Kristin Nicole Vercillo | Colorectal Surgery (proctology) | Surgeons of Lake County LLC | 1870 W Winchester Rd, Suite 112, Libertyville, IL 60048-5365 |
| William Watson | General Surgery | Surgeons of Lake County LLC | 1870 W Winchester Rd, Suite 112, Libertyville, IL 60048-5365 |
| Scott C Otto | General Surgery | Surgeons of Lake County LLC | 1870 W Winchester Rd, Suite 112, Libertyville, IL 60048-5365 |
| Lois A Barnes | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Fahd Jajeh | Cardiovascular Disease (cardiology) | Lake Heart Specialists | 1870 W Winchester Rd, Suite 241, Libertyville, IL 60048-5360 |
| Yury Shklyar | Family Medicine | 1870 W Winchester Rd, Suite 144, Libertyville, IL 60048-5359 | |
| Krzysztof P Malewicz | Certified Registered Nurse Anesthetist (crna) | Liberty Anesthesia Services LLC | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5359 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bharathi Swaminathan | Physical Medicine and Rehabilitation | 1419 Peterson Rd, Libertyville, IL 60048-1001 | |
| Svetlana F Pikus | Optometry | 1449 Peterson Rd, Libertyville, IL 60048-1001 | |
| Kerri A Kulovitz | Hand Surgery | Chicago Hand and Orthopedic Surgery Centers Sc | 1419 Peterson Rd, Libertyville, IL 60048-1001 |
| Dan M Young | Chiropractic | 283 Peterson Rd, Libertyville, IL 60048-1005 | |
| Danny Mclane | Chiropractic | Adio Chiropractic Clinic Sc | 316 Peterson Rd, Libertyville, IL 60048-1008 |
| Thomas L Conzelman | Chiropractic | Adio Chiropractic Clinic Sc | 316 Peterson Rd, Libertyville, IL 60048-1008 |
| Sara J Meline | Chiropractic | Adio Chiropractic Clinic Sc | 316 Peterson Rd, Libertyville, IL 60048-1008 |
| Elizabeth Nodine | Family Medicine | County of Lake | 18698 W Peterson Rd, Libertyville, IL 60048-1052 |
| Robin A Mathew | Nurse Practitioner | County of Lake | 18698 W Peterson Rd, Libertyville, IL 60048-1052 |
| Joshua B Nathan | Psychiatry | County of Lake | 18698 W Peterson Rd, Libertyville, IL 60048-1052 |
| Find all physicians in zip 60048 | |||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | LIBERTYVILLE + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.