NPIMap

Individual provider Active NPI

Krystal Amy Rosewell, D.O.

  • Pediatrics Physician
  • Hoffman Estates, IL
National Provider Identifier
1356640536
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.136458 Issued in IL
Practice address
2500 W. Higgins Rd.
Suite 440
Hoffman Estates, IL 60169
Phone
(847) 839-0400
Fax
(847) 839-0800
NPI assigned
Mar 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125.059749 IL
Pediatrics Physician 208000000X 036.136458 IL Primary

Addresses

Primary practice location

2500 W. Higgins Rd.
Suite 440
Hoffman Estates, IL 60169

Mailing address

2500 W. Higgins Rd.
Suite 440
Hoffman Estates, IL 60169
Phone (847) 839-0400

Other names 1

  • Krystal Amy Balla Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.136458ILMDPediatrics Physician
125.059749ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients
Bedrose Pediatrics S.C. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: krosewell132300@direct.luriechildrens.org

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": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1356640536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W. HIGGINS RD.",
            "address_2": "SUITE 440",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-839-0400",
            "fax_number": "847-839-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W. HIGGINS RD.",
            "address_2": "SUITE 440",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-839-0400",
            "fax_number": "847-839-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEWELL",
        "first_name": "KRYSTAL",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-27",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.059749",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.136458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "BALLA",
            "middle_name": "AMY",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.