Individual provider Active NPI

Diana Krishnan, APRN, PMHNP-BC, LCSW

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1235908229
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209028969 Issued in IL
Practice address
661 W Lake St Ste 2S
Chicago, IL 60661-1034
Phone
(312) 736-2865
Fax
(630) 761-7549
NPI assigned
Jan 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209028969 IL Primary

Addresses

Primary practice location

661 W Lake St Ste 2S
Chicago, IL 60661-1034

Mailing address

661 W Lake St Ste 2S
Chicago, IL 60661-1034
Phone (312) 736-2865

Other practice location 1

2319 S Damen Ave
Chicago, IL 60608-4209
Phone (773) 579-0832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241211000750 IL Practitioner - Nurse Practitioner 5597291732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209028969ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Liberti-Krishnan, PLLC Psychiatric/Mental Health CurrentSince Oct 6, 2024 Accepting new patients
Pilsen Little Village Mental Health Center Past Accepting new patients

Locations

661 W Lake St
Ste 2S
Chicago, IL 60661
Phone (312) 775-2045

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1235908229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W LAKE ST STE 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611034",
            "telephone_number": "312-736-2865",
            "fax_number": "630-761-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W LAKE ST STE 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611034",
            "telephone_number": "312-736-2865",
            "fax_number": "630-761-7549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2319 S Damen Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606084209",
            "country_code": "US",
            "telephone_number": "773-579-0832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "DIANA",
        "credential": "APRN, PMHNP-BC, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-01",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209028969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.