Active NPI
Krystal Tram DO, PHARMD
- Pharmacist
- Belvidere, IL
National Provider Identifier
1457018251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051304501
- Practice address
- 230 W Chrysler Dr
Belvidere, IL 61008-6304 - Phone
- (815) 544-4790
- NPI assigned
- Nov 29, 2021
- Last updated
- Nov 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051304501 | IL | Primary |
Addresses
Primary practice location
230 W Chrysler Dr
Belvidere, IL 61008-6304
Mailing address
3032 Kregel Dr
Rockford, IL 61109-6324
Phone (815) 980-1995
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051304501 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1457018251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3032 KREGEL DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611096324",
"telephone_number": "815-980-1995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 W CHRYSLER DR",
"city": "BELVIDERE",
"state": "IL",
"postal_code": "610086304",
"telephone_number": "815-544-4790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "KRYSTAL",
"middle_name": "TRAM",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-29",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051304501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belvidere, IL
- Susan K Delia, RPH
- Dialysis of Northern Illinois LLC (Belvidere Dialysis)
- Colleen Elizabeth Dickey, DT
- Nathan Dingess, DPT
- Kelly Brooke Dinsmore, M.S., CCC-SLP/L
- Mohammad Ismail Dogar, D.M.D
- Donohoo Pharmacy Inc. (O'Brien & Dobbins Pharmacy)
- Dr. James Chapko D.D.S., P.C.
- Dale Addison Drake, DENTIST DDS
- Elaine Carlson Drake, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.