Individual provider Active NPI

Erin Elizabeth Crain, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1467096958
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007229 Issued in IL
Practice address
1765 N Elston Ave Ste 110
Chicago, IL 60642-1501
Phone
(773) 276-1100
NPI assigned
Oct 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007229 IL Primary

Addresses

Primary practice location

1765 N Elston Ave Ste 110
Chicago, IL 60642-1501

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-3332
Phone (630) 469-2000

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
I20191112000147 IL Practitioner - Physician Assistant 6204268329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

1765 N Elston Ave
Suite 110
Chicago, IL 60642-1501
Phone (773) 276-1100

917 Remington Rd
Mattoon, IL 61938-4210
Phone (217) 205-3376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalskin Medical Group Il PLLC Physician Assistant CurrentSince Oct 1, 2023 Accepting new patients
Vitalskin Medical Group Il PLLC Past Accepting new patients

Locations

1765 N Elston Ave
Ste 110
Chicago, IL 60642
Phone (773) 276-1100

917 Remington Rd
Mattoon, IL 61938
Phone (217) 205-3376

1111 W Kenyon Rd
Ste A
Urbana, IL 61801

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": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1467096958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606743332",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 N ELSTON AVE STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606421501",
            "telephone_number": "773-276-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIN",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.