One provider matched this enrollment ID.
Enrollment ID I20040702000644 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.
Practitioner
- I20040702000644Certified Registered Nurse Anesthetist (CRNA)IL
Source: CMS PECOS public enrollment file.
Secondary identifiers
Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.
Other
- 041321643IL· Issued by IL LICENSE #
- 0841504038IL· Issued by BCBS OF ILLINOIS
- L031806IL· Issued by CHAMPUS/TRICARE
- 209-005041IL· Issued by IL APN LICENSE #
- 71427IL· Issued by AANA#
Source: NPPES public registry.
ReferenceAbout Medicare Enrollment IDs
A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.