CRYSTAL S JESENICK (NPI# 1396831616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396831616 |
| Entity Type | Individual |
| Full Name | CRYSTAL S JESENICK |
| Other Name | CRYSTAL L SPIRKOFF |
| Credential | A.N.P.-C |
| Practice Address |
922 Talon Dr Suite B O Fallon IL 62269-1848 |
| Mailing Address |
825 Saybrook Falls Dr Fairview Heights IL 62208-2168 |
| Practice Telephone | 6189725641 |
| Practice Fax Number | 3142705283 |
| Mailing Telephone | 6189725641 |
| Mailing Fax Number | 3142705283 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2015-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209006003 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 427014204 | 05 |
| Street Address |
922 TALON DR SUITE B |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-1848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306889266 | Amanda Joy Buffington | Chiropractor | 922 Talon Dr, Suite B, O Fallon, IL 62269-1848 | 2006-06-14 |
| 1003361783 | Weston Allen Holzinger | Chiropractor | 922 Talon Dr, Suite B, O Fallon, IL 62269-1848 | 2016-08-23 |
| 1922476241 | Whole Health Family Practice, PC | Nurse Practitioner | 922 Talon Dr, Suite B, O Fallon, IL 62269-1848 | 2015-09-02 |
| 1457534927 | Whole Health Chiropractic Sc | Chiropractor | 922 Talon Dr, Suite B, O Fallon, IL 62269-1848 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194923151 | Laura L Hill | Nurse Practitioner | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2007-07-10 |
| 1295775989 | Pamela L Kuda | Nurse Practitioner | 1464 Sunburst Dr, O Fallon, MO 63366-6348 | 2006-06-08 |
| 1992287379 | Elizabeth Anne Frost | Nurse Practitioner | 916 Talon Dr Ste 102, O Fallon, IL 62269-1848 | 2018-09-03 |
| 1700328523 | Emily Maire Boyle | Nurse Practitioner | 4122 Keaton Crossing Blvd, O Fallon, MO 63368-8218 | 2016-11-10 |
| 1699135434 | Laura Christine Thomas | Nurse Practitioner | 4122 Keaton Crossing Blvd, Suite 102, O Fallon, MO 63368-8218 | 2016-03-04 |
| 1770949125 | Patricia J Relleke | Nurse Practitioner | 916 Talon Dr, Suite 102, O Fallon, IL 62269-1848 | 2016-01-14 |
| 1407295355 | Jenna A Sanders | Nurse Practitioner | 5551 Winghaven Blvd, Ste 290, O Fallon, MO 63368-3617 | 2013-06-24 |
| 1831209840 | Jeannine Ayers | Nurse Practitioner | 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998553 | Melissa Litwin | Nurse Practitioner | 9127 Burlington Ave, Brookfield, IL 60513-1939 | 2020-10-06 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1518506625 | Lila Macalinga Rivera | Nurse Practitioner | 17w335 16th St, Oakbrook Terrace, IL 60181-4030 | 2020-01-06 |
| 1922642495 | Christine Nacar | Nurse Practitioner | 1232 Le Moyne Ave, Romeoville, IL 60446-4180 | 2019-10-29 |
| 1144871344 | Wensheng Tracy Wu | Nurse Practitioner | 1555 Barrington Rd Ste 1200, Hoffman Estates, IL 60169-5036 | 2019-09-27 |
| 1881245314 | Mkbb LLC | Nurse Practitioner | 1212 E Algonquin Rd, Algonquin, IL 60102-5446 | 2019-09-25 |
| 1225681455 | Jinu Joss | Nurse Practitioner | 9939 N Warren Oval, Niles, IL 60714-1044 | 2019-07-17 |
| 1659830057 | Ginger Dean | Nurse Practitioner | 2843 Chicago Rd, South Chicago Heights, IL 60411-4736 | 2019-03-15 |
| 1770048910 | Amanda K Honchell I | Nurse Practitioner | 401 W Madison St, Mount Carroll, IL 61053-9485 | 2019-02-01 |
| 1548725799 | Grace Nwaka Wabomnor | Nurse Practitioner | 17 E Grandview Dr, South Holland, IL 60473-1099 | 2019-02-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.