Krystal Weiand, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.006378 Issued in IL

Practice address

3808 N Lincoln Ave Ste 101
Chicago, IL 60613-7499

Phone

(773) 677-4300

Fax

(773) 423-8429

NPI assigned

Oct 4, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00174
• Direct secure messaging: ksimpraphone@directaddress.net

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  Multi-Specialty

  NPD (past)
• Kaminska Dermatology

  • Dermatology Physician
  • Chicago, IL
  • NPI 1093377731
  NPD (past)

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1073023016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 N LINCOLN AVE STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606137499",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 N LINCOLN AVE STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606137499",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Erie St Ste 530",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112792",
            "country_code": "US",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIAND",
        "first_name": "KRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2024-01-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ezekiel Tianyi Wei, MD
• Grace Wei, MD MPH MS
• Helen Wei, MD
• Joshua Wei
• Zhishuo Wei
• Christine Weible-Cruz, LCSW
• Caitlin Weichelt, CF-SLP
• Ralph R Weichselbaum, M.D.
• Jessica Hackman Weidel, LCPC, NCC
• Gwen D Weidell, PTA

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.