Individual provider Active NPI

Taylor Johnson, FNP-BC

  • Family Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1467122697
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277003798 Issued in IL
Practice address
525 E Congress Pkwy
Crystal Lake, IL 60014-6245
Phone
(815) 479-8020
NPI assigned
Sep 19, 2021
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277003798 IL Primary

Addresses

Primary practice location

525 E Congress Pkwy
Crystal Lake, IL 60014-6245

Mailing address

24 Echo HL
Lake in the Hills, IL 60156-1306

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
I20211216001224 IL Practitioner - Nurse Practitioner 1355732843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Lake Immediate Care Physicians LTD.Group PAC ID 2961783139, 17 clinicians

Practice addresses (Care Compare)

525 E Congress Pkwy
Suite 100
Crystal Lake, IL 60014-6271
Phone (626) 327-6795

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277003798ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Lake Immediate Care Physicians LTD. CurrentSince Dec 1, 2021 Accepting new patients
Mobile Anesthesiologists Chicago LLC PastSince Aug 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation PastSince Sep 28, 2021 Accepting new patients

Locations

525 E Congress Pkwy
Ste 100
Crystal Lake, IL 60014
Phone (626) 327-6795

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": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1467122697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ECHO HL",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146245",
            "telephone_number": "815-479-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAYLOR",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-19",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277003798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.