Individual provider Active NPI

Krista Dionne Young, DO

  • Internal Medicine Physician
  • Berwyn, IL
National Provider Identifier
1851853832
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.161921 Issued in IL
Practice address
6447 Cermark Rd
Berwyn, IL 60402
Phone
(773) 254-1400
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036.161921 IL Primary

Addresses

Primary practice location

6447 Cermark Rd
Berwyn, IL 60402

Mailing address

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-7147

Other practice location 1

1 Hospital Plz
Stamford, CT 06902-3602
Phone (203) 276-7147

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209002363 IL Practitioner - Internal Medicine 8022487222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alivio Medical Center, Inc.Group PAC ID 5698840924, 23 clinicians

Practice addresses (Care Compare)

6447 Cermak Rd
Berwyn, IL 60402-2311
Phone (773) 254-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Illinois PC Internal Medicine CurrentSince Sep 11, 2023 Accepting new patients
Alivio Medical Center, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Alivio Medical Center, Inc. Current Accepting new patients
Alivio Medical Center CurrentSince Dec 1, 2022 Accepting new patients

Locations

6447 Cermak Rd
Berwyn, IL 60402
Phone (773) 254-1400

6447 Cermak Rd
Ste 100
Berwyn, IL 60402
Phone (773) 254-1400

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

966 W 21st St
Chicago, IL 60608
Phone (773) 254-1400

2355 S Western Ave
Chicago, IL 60608
Phone (773) 254-1400

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220

550 Warrenville Rd
Ste 200
Lisle, IL 60532
Phone (312) 776-2422

Organizations & group practices 4

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 3

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1851853832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-7147",
            "fax_number": "203-276-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6447 CERMARK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "773-254-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069023602",
            "country_code": "US",
            "telephone_number": "203-276-7147",
            "fax_number": "203-276-7368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KRISTA",
        "middle_name": "DIONNE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.161921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.