Crystal Ashley Kannankeril, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008430 Issued in IL

Practice address

30 N Michigan Ave
Suite 1909
Chicago, IL 60602-3402

Phone

(312) 834-3076

NPI assigned

Mar 14, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Crystal Kannankeril, PSYD LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1336658848
  NPD Authorized official
• Crystal Kannankeril, PSYD LLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1902382351
  NPD Authorized official

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1639410749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-834-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1909",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-834-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNANKERIL",
        "first_name": "CRYSTAL",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-14",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supaluck Kanjanauthai
• Zehra S Kanji-Ghaziani
• Naveen A Kanji, MD
• Allison Kannam
• Annie Kannankeril, PHARM.D.
• Maryann Kannappan
• Sandhya Shri Kannayiram, MD
• Manasa Kanneganti, DDS
• Sanjana Kannikeswaran
• Michele Kannin, M.D.

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.