Jacqueline E. Scalissi
Jacqueline E Bertucci · Nurse Anesthetist, Certified Registered

Address: 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754
Phone: 8158774848

Jacqueline E. Scalissi (NPI# 1477826311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1477826311
Entity Type Individual
Full Name Jacqueline E. Scalissi
Other Name Jacqueline E Bertucci
Credential CRNA
Gender Female
Practice Address 2202 Harlem Rd
Suite 200
Loves Park
IL 61111-2754
Practice Telephone 8158774848
Practice Fax Number 8156545342
Mailing Address 2202 Harlem Rd
Suite 200
Loves Park
IL 61111-2754
Mailing Telephone 8158774848
Mailing Fax Number 8156545342
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2012-02-22
Last Update Date 2014-07-16

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 163WC0200X Registered Nurse · Critical Care Medicine Nursing Service Providers 041.354363 IL
Yes 367500000X Nurse Anesthetist, Certified Registered Physician Assistants & Advanced Practice Nursing Providers 209.010531 IL

Physician Overview

NPI 1477826311
PAC ID by PECOS 1951545805
Professional Enrollment ID I20130917000063
Full Name Jacqueline E Scalissi
Organization Legal Name ROCKFORD ANESTHESIOLOGISTS ASSOCIATED LLC
Phone Number 8159684400
Gender F
Graduation Year 2013
Primary Specialty CERTIFIED REGISTERED NURSE ANESTHETIST
Group Practice PAC ID 5597668004
Number of Group Practice Members 62
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
140228 SWEDISH AMERICAN HOSPITAL
140233 OSF SAINT ANTHONY MEDICAL CENTER

Office Location

Street Address 2202 HARLEM RD
SUITE 200
City LOVES PARK
State IL
Zip Code 61111-2754

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639128598 Rockford Anesthesiologists Associated, L.l.c. Anesthesiology 2202 Harlem Rd, Loves Park, IL 61111-2754 2006-05-09
1932653516 Timothy Michael Dolan Registered Nurse 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 2016-08-11
1699229369 Jason C Stern Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2016-08-10
1417339656 Erin B Butler Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2015-06-24
1336545854 Scott A Waggoner Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-11-11
1417353319 Paula M. Dobrowolska Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 2014-11-05
1063815645 Kelly N. Carroll Registered Nurse 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-09-26
1639571227 Nicole Nelson Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-09-25
1427459007 Ashley Hall Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-09-15
1720497498 Jason Huffman Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 2014-08-07
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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 Osf Saint Francis, Inc Pharmacy 9951 Rock Cut Crossing, Loves Park, IL 61111 2006-07-30
1386670529 Joseph L Digirolamo Chiropractor 116 East Riverside Blvd, Loves Park, IL 61111 2006-06-22
1720045859 Metro Medical Services Inc Ambulance 5112 Forest Hills Ct, Loves Park, IL 61111 2006-05-01
1669438230 Karen R Boettner Advanced Practice Midwife 6550 Broadcast Parkway, Loves Park, IL 61111 2006-04-24
1902878358 Edward Yavitz Ophthalmology 4105 North Perryville Rd, Loves Park, IL 61111 2006-02-01
1316338270 Nicholas Miramontes Chiropractor 1820 Windsor Rd, Loves Park, IL 61111 2015-02-13
Find all providers in zip 61111

Taxonomy Information

Taxonomy Code 367500000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Anesthetist, Certified Registered

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952359861 Tamara Wojciechowski Nurse Anesthetist, Certified Registered 6550 E Riverside Blvd, Loves Park, IL 61111-4424 2006-05-04
1982609343 Jane A. Rickman Nurse Anesthetist, Certified Registered 2202 Harlem Road, Suite 200, Loves Park, IL 61111-2754 2005-06-14
1992228365 Becky L Madsen Nurse Anesthetist, Certified Registered 2202 Harlem Rd Ste 200, Loves Park, IL 61111-2754 2017-07-18
1699229369 Jason C Stern Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2016-08-10
1417339656 Erin B Butler Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2015-06-24
1336545854 Scott A Waggoner Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-11-11
1417353319 Paula M. Dobrowolska Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 2014-11-05
1639571227 Nicole Nelson Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-09-25
1427459007 Ashley Hall Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Loves Park, IL 61111-2754 2014-09-15
1720497498 Jason Huffman Nurse Anesthetist, Certified Registered 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 2014-08-07
Find all providers in LOVES PARK

Competitor

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City LOVES PARK
Zip Code 61111

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Dataset Information

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.

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