Active NPI
Crystal Cole, APN
- Psychiatric/Mental Health Nurse Practitioner
- Oak Park, IL
National Provider Identifier
1972902260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209011659
- Practice address
- 14 Lake St
Oak Park, IL 60302-2606 - Phone
- (708) 383-0113
- Fax
- (708) 383-3168
- NPI assigned
- Aug 22, 2014
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209011659 | IL | Primary |
Addresses
Primary practice location
14 Lake St
Oak Park, IL 60302-2606
Mailing address
14 Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 26, 2020 through Oct 26, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209011659 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1972902260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 LAKE ST",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022606",
"telephone_number": "708-383-0113",
"fax_number": "708-383-3168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 LAKE ST",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022606",
"telephone_number": "708-383-0113",
"fax_number": "708-383-3168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "CRYSTAL",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-22",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209011659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.