Individual provider Active NPI

Kristie Veronica Blazys

  • Student in an Organized Health Care Education/Training Program
  • Plainfield, IL
National Provider Identifier
1003786401
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
13550 Lincoln Highway
Suite 100
Plainfield, IL 60544
Phone
(815) 436-1655
NPI assigned
Nov 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL Primary

Addresses

Primary practice location

13550 Lincoln Highway
Suite 100
Plainfield, IL 60544

Mailing address

500 Wilcox St
Joliet, IL 60435-6169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1003786401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WILCOX ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13550 LINCOLN HIGHWAY",
            "address_2": "SUITE 100",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "60544",
            "telephone_number": "815-436-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZYS",
        "first_name": "KRISTIE",
        "middle_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.