Crystal Kannankeril, PSYD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008430 Issued in IL

Legal business name

CRYSTAL KANNANKERIL, PSYD LLC

Practice address

30 N Michigan Ave Ste 502
Chicago, IL 60602-3834

Phone

(312) 834-3076

NPI assigned

Jul 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Kannankeril, PSYDNPI 1639410749

Title

Owner/Psychologist

Phone

(312) 834-3076

Specialties & licenses 1

Addresses

Tax ID family

Crystal Kannankeril PSYD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Crystal Kannankeril, PSYD LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1336658848
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crystal Ashley Kannankeril, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1639410749
  NPD Authorized official

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1902382351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023834",
            "telephone_number": "312-834-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023834",
            "telephone_number": "312-834-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL KANNANKERIL, PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "KANNANKERIL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-834-3076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Thomas Cryder, PHARM.D.
• Crystal Cole Pmhnp-BC LLC
• Crystal F. Clair, Inc
• Crystal Johnson, Psy.D, LLC
• Crystal Kannankeril, PSYD LLC
• Crystal Lynn Cole Pmhnp-BC LLC
• Crystal R. Patel, D.D.S, PC
• Crystal Thomas, Psychotherapist
• Crystal Vision Center
• Crystal Wong O.D., P.C.

• 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 Jul 18, 2018; 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.