Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan S Harris, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1629638788

Ethan S Harris, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Loves Park, Illinois. Qualified in 2019, 7 years ago. Practices with Rockford Anesthesiologists Associated LLC, a 61-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
7
Licensed in
IL
In the registry since
2019
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

2202 Harlem Rd Ste 200
Loves Park, IL 61111-2754
Phone: (815) 877-4848
Fax: (815) 636-6125
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 209019805 (IL)

Record details

NPI number1629638788
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedJune 19, 2019
Last updated in NPPESAugust 12, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Rockford Anesthesiologists Associated Llc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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