Individual provider Active NPI

Krista Wunsch, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1811510506
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008391 Issued in IL
Practice address
200 S Wacker Dr FL 31
Chicago, IL 60606-5877
Phone
(866) 849-0692
NPI assigned
May 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085008391 IL Primary
Physician Assistant 363A00000X 50010270RX OH
Physician Assistant 363A00000X 0010-16712 NC
Physician Assistant 363A00000X 11698 AZ

Addresses

Primary practice location

200 S Wacker Dr FL 31
Chicago, IL 60606-5877

Mailing address

1616 Grand Ave Ste a
Waukegan, IL 60085-3676
Phone (847) 249-1733

Other practice location 1

1616 Grand Ave Ste A
Waukegan, IL 60085-3676
Phone (847) 249-1733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210823001741 IL Practitioner - Physician Assistant 9931504370 Reassigns benefits to 1 organization
I20250417002997 MI Practitioner - Physician Assistant 9931504370 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11698AZMDPhysician Assistant
085008391ILMDPhysician Assistant
50010270RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Waukegan Clinic Corp CurrentSince Oct 1, 2021 Accepting new patients
Oncology Hematology Associates of Northern Illinois, LTD CurrentSince Oct 1, 2021 Accepting new patients

Locations

200 S Greenleaf St
Ste L
Gurnee, IL 60031
Phone (847) 360-7888

1616 Grand Ave
Ste A
Waukegan, IL 60085
Phone (847) 249-1733

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1811510506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 GRAND AVE STE A",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853676",
            "telephone_number": "847-249-1733",
            "fax_number": "847-782-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WACKER DR FL 31",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065877",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 Grand Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600853676",
            "country_code": "US",
            "telephone_number": "847-249-1733",
            "fax_number": "847-782-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WUNSCH",
        "first_name": "KRISTA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008391",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50010270RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16712",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11698",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.