Individual
CRYSTAL GOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
213 W INSTITUTE PL STE 500, CHICAGO, IL 60610-8792
(773) 923-3103
(773) 200-3820
Mailing address
332 S MICHIGAN AVE STE 900, CHICAGO, IL 60604-4393
(773) 923-3103
(773) 200-3820
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209025394
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN.CPN.0029178
OH
Other
Enumeration date
07/01/2021
Last updated
03/14/2026
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