Christina Iyer, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

277001063 Issued in IL

Practice address

629 N Galena Ave
Dixon, IL 61021-1664

Phone

(815) 288-1235

Fax

(815) 288-0034

NPI assigned

Sep 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Conventions Psychiatry & Counseling, P.C.

  • Psychiatry Physician
  • Warrenville, IL
  • NPI 1053355289
  NPD

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1023566726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 IL ROUTE 26",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219764",
            "telephone_number": "815-440-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N GALENA AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211664",
            "telephone_number": "815-288-1235",
            "fax_number": "815-288-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Weaver Pkwy Ste 100-A",
            "address_purpose": "LOCATION",
            "city": "Warrenville",
            "state": "IL",
            "postal_code": "605553919",
            "country_code": "US",
            "telephone_number": "630-416-8289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IYER",
        "first_name": "CHRISTINA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014747",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041311863",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277001063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha A. Hutchings, MHP
• Illinois Correctional Industries
• Illinois Department of Human Services
• Sierra Nicole Inghram, LCPC
• Tyler Inghram
• Laxman S Iyer, M.D.
• Jack Mabley Developmental Center
• Jack Mabley Developmental Center
• Jack Mabley Developmental Center
• Jack Mabley Developmental Center

• Psychiatric/Mental Health Nurse Practitioner in Dixon, IL
• Providers in Dixon, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.