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

Jake Alan Kimlicka

Individual provider Certified Registered Nurse Anesthetist · NPI 1508529942

Jake Alan Kimlicka is a Certified Registered Nurse Anesthetist (CRNA) in Maywood, Illinois. Qualified in 2021, 5 years ago. Practices with Loyola University Medical Center, a 946-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2021
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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (888) 584-7888
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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 209.024183 (IL)

Record details

NPI number1508529942
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 21, 2021
Last updated in NPPESMay 21, 2022
Certification dateMay 21, 2022
Mailing address2160 S 1st Ave, Maywood, IL 60153-3328

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Loyola University Medical Center — 946 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Maywood