Crystal Banks Daniels, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301057725 Issued in MI

Practice address

228 E Lake St
Addison, IL 60101-2889

Phone

(630) 835-1430

Fax

(630) 835-1433

NPI assigned

Jul 8, 2005

Last updated

Feb 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crystalbanks@mykidsdocs.allscriptsdirect.net
• FHIR API: https://fhir4.healow.com/fhir/r4/JCEHCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Refuah Health Center

  • Clinic/Center
  • Chicago, IL
  • NPI 1518601004
  Medicare reassignment NPD
• Midwest Refuah Health Center

  • Radiology Clinic/Center
  • Chicago, IL
  • NPI 1962219691
  NPD
• Midwest Refuah Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1982301370
  NPD
• Midwest Refuah Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1003622101

  Pediatrics

  NPD (past)
• My Kids Doc-Southfield

  • Pediatric Adolescent Medicine Physician
  • Southfield, MI
  • NPI 1730187840

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1962400556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E LAKE ST",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012889",
            "telephone_number": "630-835-1430",
            "fax_number": "630-835-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 E LAKE ST",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012889",
            "telephone_number": "630-835-1430",
            "fax_number": "630-835-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "CRYSTAL",
        "middle_name": "BANKS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301057725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4483489",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick William Crowe
• Paulina Maria Cygan
• Rosina A. D'Avola, M.S., CCC-SLP/L
• Dad & Kids, LLC (Comfort Keepers)
• Dale Liaugminas, M.D. S.C.
• B David Das, PHD
• Yasmine Davila
• Alexandra Davis, FNP-BC
• Farzana Dawood
• Yahtziri De Los Santos

• Pediatrics Physician in Addison, IL
• Providers in Addison, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.

Verify at the official NPI Registry.