Krista Joanne Mitch, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209022698 Issued in IL

Practice address

3212 W Wabansia Ave
Chicago, IL 60647-4923

Phone

(773) 517-3271

NPI assigned

Apr 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1447870290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 W WABANSIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474923",
            "telephone_number": "773-517-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 W WABANSIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474923",
            "telephone_number": "773-517-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCH",
        "first_name": "KRISTA",
        "middle_name": "JOANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041437794",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bogusia Miszczyszyn
• Ryan Bernard Mitacek, MD
• Mital Spatz DDS PC
• Rohan Mital, MD
• Michael Florentino Mitarotondo, P.T.A.
• Mitchell Foot & Ankle PC
• Mitchell Goldflies MD SC
• Mitchell Rotenberg Inc
• Sheila Faye Mitchell-Erb, LCSW
• Alexandra Mitchell, MD

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.