Mr Richard Earl Boren, CRNA | |
2 S Hospital Dr, Murphysboro, IL 62966-3333 | |
(618) 684-3156 | |
(618) 529-0529 |
Full Name | Mr Richard Earl Boren |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 40 Years |
Location | 2 S Hospital Dr, Murphysboro, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346353117 | NPI | - | NPPES |
214881 | Other | IL | MEDICARE MULTISPECIALTY GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 209-005603 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Joseph Memorial Hospital | Murphysboro, IL | Hospital |
Southern Illinois Hospital Services Dba Herrin Hospital | Herrin, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Marion Anesthesia Company Llc | 3577522010 | 7 |
Northstar Anesthesia Of Illinois, Llc | 4688893878 | 259 |
Entity Name | Marion Anesthesia Company Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790721579 PECOS PAC ID: 3577522010 Enrollment ID: O20041008000899 |
Entity Name | Southern Illinois Medical Services Nfp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
Entity Name | Northstar Anesthesia Of Illinois, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962822395 PECOS PAC ID: 4688893878 Enrollment ID: O20140922000405 |
Mailing Address | Practice Location Address |
---|---|
Mr Richard Earl Boren, CRNA 2 S Hospital Dr, Murphysboro, IL 62966-3333 Ph: (618) 684-3156 | Mr Richard Earl Boren, CRNA 2 S Hospital Dr, Murphysboro, IL 62966-3333 Ph: (618) 684-3156 |
John D Lundeberg, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2 S Hospital Dr, Murphysboro, IL 62966 Phone: 618-684-3156 Fax: 618-529-0529 | |
Louise Mary Vaughn, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2 S Hospital Dr, Murphysboro, IL 62966 Phone: 618-684-3156 |