Active NPI
Krystina Banks, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1801576384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.025416
- Practice address
- 1400 W Greenleaf Ave
Chicago, IL 60626-2805 - Phone
- (312) 952-6755
- NPI assigned
- Jul 20, 2023
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.025416 | IL | Primary |
Addresses
Primary practice location
1400 W Greenleaf Ave
Chicago, IL 60626-2805
Mailing address
10443 S Hale Ave Apt 3a
Chicago, IL 60643-2833
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.025416 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Oaks Mid-West LLC | Current | Accepting new patients |
Locations
720 Raymond Dr
Naperville, IL 60563
Phone (630) 355-0220
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1801576384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10443 S HALE AVE APT 3A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606432833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 W GREENLEAF AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606262805",
"telephone_number": "312-952-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKS",
"first_name": "KRYSTINA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-20",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.025416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.