Individual provider Active NPI

Allison Anne Teliszczak, CNP

  • Family Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1679941819
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277002816 Issued in IL
Practice address
1095 Pingree Rd Ste 108
Crystal Lake, IL 60014-1726
Phone
(815) 459-6655
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 277002816 IL Primary

Addresses

Primary practice location

1095 Pingree Rd Ste 108
Crystal Lake, IL 60014-1726

Mailing address

10350 Haligus Rd
Huntley, IL 60142-9545
Phone (815) 338-6600

Other identifiers 2

IdentifierTypeStateIssuer
277002816OtherILSTATE LICENSE
209013024OtherILSTATE LICENSE

Other names 1

  • Allison Anne Schacht Former name

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
I20171013003017 IL Practitioner - Nurse Practitioner 7214202480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine for McHenry CountyGroup PAC ID 0840296240, 3 clinicians

Practice addresses (Care Compare)

1095 Pingree Rd
Suite 108
Crystal Lake, IL 60014-1726
Phone (815) 459-6655

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277002816ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine for McHenry County CurrentSince Jan 30, 2024 Accepting new patients

Locations

1095 Pingree Rd
Ste 108
Crystal Lake, IL 60014
Phone (815) 459-6655

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1679941819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 HALIGUS RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429545",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 PINGREE RD STE 108",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141726",
            "telephone_number": "815-459-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELISZCZAK",
        "first_name": "ALLISON",
        "middle_name": "ANNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277002816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "277002816",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209013024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "SCHACHT",
            "middle_name": "ANNE",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.