Individual provider Active NPI

Amanda Jean Kriebs

  • Psychiatric/Mental Health Nurse Practitioner
  • Galena, IL
National Provider Identifier
1346714755
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209032041 Issued in IL
Practice address
1 Medical Center Dr
Galena, IL 61036-8118
Phone
(815) 777-1340
Fax
(815) 776-7274
NPI assigned
Jan 18, 2019
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209032041 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209032041 IL Primary
Registered Nurse 163W00000X 041438972 IL

Addresses

Primary practice location

1 Medical Center Dr
Galena, IL 61036-8118

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3877

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address midwestmedical@midwestmedicalcenter.cernerdirect.com Direct

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
I20250502002039 IL Practitioner - Nurse Practitioner 1052838059 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Medical CenterGroup PAC ID 5698771848, 36 clinicians
Yusuf Salah LLCGroup PAC ID 3577895176, 45 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Galena, IL 61036

1 Medical Ctr Dr
Galena, IL 61036-8118
Phone (815) 777-1340

10902 Dogleg RDG
Galena, IL 61036-8206
Phone (815) 776-7265

15 Wedgewood Dr
Galena, IL 61036-8677
Phone (815) 776-7265

412 /2 S Main St
Suite 202
Galena, IL 61036-2231
Phone (815) 777-1340

6756 Stephanie CT
Galena, IL 61036-8801
Phone (815) 776-7265

7300 W College Dr
Suite 101
Palos Heights, IL 60463-1181
Phone (708) 448-8470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041438972ILMDRegistered Nurse
209032041ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Medical Center CurrentSince Apr 3, 2025 Accepting new patients
Midwest Medical Center CurrentSince Apr 3, 2025 Accepting new patients
Yusuf Salah LLC Psychiatric/Mental Health CurrentSince May 1, 2025 Accepting new patients

Locations

19550 Governors Hwy
Flossmoor, IL 60422
Phone (708) 799-8400

1 Medical Center Dr
Galena, IL 61036
Phone (815) 776-7381

6321 Dempster St
Morton Grove, IL 60053

8333 W Golf Rd
Niles, IL 60714
Phone (847) 966-9190

7300 W College Dr
Ste 101
Palos Heights, IL 60463
Phone (708) 448-8470

Interoperability endpoints

  • Direct secure messaging: midwestmedical@midwestmedicalcenter.cernerdirect.com

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

Hospital & facility affiliations 2

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1346714755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368118",
            "telephone_number": "815-777-1340",
            "fax_number": "815-776-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEBS",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209032041",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209032041",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041438972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "midwestmedical@midwestmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Midwest Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Medical Center Dr",
            "city": "Galena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610368118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Galena, IL

Sources for this page

Verify at the official NPI Registry.