Individual provider Active NPI

Kristy Kiermaier, FNP-BC

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1073227740
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2022030275 Issued in IL
Practice address
1620 W Harrison St # 11E
Chicago, IL 60612-3801
Phone
(312) 947-1100
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2022030275 IL Primary

Addresses

Primary practice location

1620 W Harrison St # 11E
Chicago, IL 60612-3801

Mailing address

4950 N Western Ave Apt 4E
Chicago, IL 60625-8344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230628003922 IL Practitioner - Nurse Practitioner 1850750571 Reassigns benefits to 1 organization
I20231213002218 IN Practitioner - Nurse Practitioner 1850750571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 158
Chicago, IL 60612-3841
Phone (312) 942-8910

9200 Calumet Ave
Suite E107
Munster, IN 46321-2885
Phone (219) 806-6585

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
  • Community Hospital Hospital, Munster, IN, CCN 150125
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2022030275ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Jul 10, 2023 Accepting new patients
Rush University Medical Center CurrentSince Jul 10, 2023 Accepting new patients
Oak Dermatology LLC Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1620 W Harrison St
#11E
Chicago, IL 60612
Phone (312) 947-1100

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 1159
Chicago, IL 60612
Phone (312) 942-5020

1200 S York St
Ste 2000
Elmhurst, IL 60126
Phone (331) 221-9002

4885 Hoffman Blvd
Ste 400
Hoffman Estates, IL 60192
Phone (847) 255-9697

2135 City Gate Ln
Ste 350
Naperville, IL 60563
Phone (864) 625-3376

2011 York Rd
Ste 200A
Oak Brook, IL 60523

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

10448 S Pulaski Rd
Oak Lawn, IL 60453
Phone (708) 424-7705

650 Dickinson Rd
Chesterton, IN 46304
Phone 21926346008228

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

9200 Calumet Ave
Ste E107
Munster, IN 46321
Phone (219) 806-6585

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1073227740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 N WESTERN AVE APT 4E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST # 11E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "312-947-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERMAIER",
        "first_name": "KRISTY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "2022030275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.