Crystal Balfour, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

071.008702 Issued in IL

Practice address

1500 South California Avenue
NR 553
Chicago, IL 60608

Phone

(773) 257-4750

Fax

(773) 257-4753

NPI assigned

Jun 13, 2011

Last updated

Jan 22, 2016By the provider in NPPES

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• In Bloom Behavioral Health, PLLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1124866132
  NPD Authorized official
• Mount Sinai Community Foundation

  dba Sinai Medical Group

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  NPD
• Mount Sinai Community Foundation

  dba Sinai Medical Group

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982657854
  NPD

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1184919789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SOUTH CALIFORNIA AVENUE",
            "address_2": "NR 553",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-257-4750",
            "fax_number": "773-257-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTH CALIFORNIA AVENUE",
            "address_2": "NR 553",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-257-4750",
            "fax_number": "773-257-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALFOUR",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071.008702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Bales
• Melissa Rose Bales, BSN, RN
• Rena Balesh, MHP
• Anthony J Balesteri, MD
• Kerri Baley
• Dmitry Balian, MD
• Casey Balicki, LCSW
• Daniel Balikov, MD, PHD
• Carl M Balingit, L.AC.
• Rebecca H Balinnang, MS, RD, LDN

• Clinical Child & Adolescent Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Child & Adolescent Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.