Krista Puckett (NPI# 1104318666, PAC ID# 4688924707) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1104318666 |
| PAC ID by PECOS | 4688924707 |
| Professional Enrollment ID | I20180911000196 |
| Full Name | Krista Puckett |
| Organization Legal Name | NORTHWESTERN MEDICAL FACULTY FOUNDATION |
| Address |
635 N Fairbanks Ct Fl 1 Chicago IL 60611-5435 |
| Phone Number | 3124723173 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4587576814 |
| Number of Group Practice Members | 2103 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140281 | NORTHWESTERN MEMORIAL HOSPITAL |
| 140130 | NORTHWESTERN LAKE FOREST HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 | 3124723173 | NORTHWESTERN MEDICAL FACULTY FOUNDATION |
| Organization Legal Name | NORTHWESTERN MEDICAL FACULTY FOUNDATION |
| Physicians | 2248 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle A Young | Registered Dietitian Or Nutrition Professional | Northwestern Medical Faculty Foundation | 800 N Westmoreland Rd, Suite 201, Lake Forest, IL 60045-1687 |
| Guadalupe Rodriguez | Nurse Practitioner | Northwestern Medical Faculty Foundation | 350 S Waukegan, Suite 150, Deerfield, IL 60015-5239 |
| Walter J Liszewski | Dermatology | Northwestern Medical Faculty Foundation | 676 N St Clair, 1600 Dept of Dermatology, Chicago, IL 60611-2997 |
| Keith P Leitzen | Otolaryngology | Northwestern Medical Faculty Foundation | 800 N W Moreland Rd, Suite 102, Lake Forest, IL 60045-1687 |
| Joshua G Cahan | Neurology | Northwestern Medical Faculty Foundation | 675 N Saint Clair St, Suite 20 100, Chicago, IL 60611-5970 |
| Jennifer Lee | Ophthalmology | Northwestern Medical Faculty Foundation | 259 E Erie, Lavin 1520, Chicago, IL 60611-2987 |
| David S Burstein | Internal Medicine | Northwestern Medical Faculty Foundation | 676 N Saint Clair, Chicago, IL 60611-2927 |
| Richard R Clark | Family Medicine | Northwestern Medical Faculty Foundation | 1475 E Belvidere Rd, Pavilion C Suite 385, Grayslake, IL 60030-2026 |
| Edward J Tanner Iii | Gynecological Oncology | Northwestern Medical Faculty Foundation | 250 E Superior, 2304 Nwmff Prent Wmn Hosp, Chicago, IL 60611-2914 |
| Katie Marie Reidy | Physician Assistant | Northwestern Medical Faculty Foundation | 350 S Waukegan Rd, Deerfield, IL 60015-5239 |
| Street Address |
635 N FAIRBANKS CT FL 1 |
| City | CHICAGO |
| State | IL |
| Zip | 60611-5435 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristin Leigh Docter | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Jennifer Staskowicz | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Mary Eck | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Aimee M Halcomb | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Elizabeth Jager | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Kelly Gleason Murphy | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Emily Peiffer | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| James G Delis | Family Medicine | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Madelyn M Geary | Physician Assistant | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Andrea Finley | Nurse Practitioner | Northwestern Medical Faculty Foundation | 635 N Fairbanks Ct, Fl 1, Chicago, IL 60611-5435 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph R Spatafora | Psychiatry | 600 N Mcclurg Court, Suite 4411a, Chicago, IL 60611 | |
| Barbara S Rocah | Psychiatry | 1110 N Lake Shore Dr, Apt 30s, Chicago, IL 60611-1022 | |
| Loretta De Koster | Optometry | 129 E Oak St, Chicago, IL 60611-1202 | |
| Robert Lee Walton Jr. | Plastic and Reconstructive Surgery | 60 E Delaware Pl, Suite 1430, Chicago, IL 60611-1495 | |
| Michael R Abern | Urology | The Board of Trustees of The University of Illinois | 900 N Michigan Ave, Chicago, IL 60611-1542 |
| Lawrence S Ross | Urology | The Board of Trustees of The University of Illinois | 900 N Michigan Ave, Chicago, IL 60611-1542 |
| Kelly Dineen | Psychologist, Clinical | One E Delaware Place, Suite 501, Chicago, IL 60611-1666 | |
| Charles Zugerman | Dermatology | Illinois Dermatology Institute LLC | 1 E Delaware Pl, Suite 501, Chicago, IL 60611-1666 |
| Jacob Mp Bloom | Plastic and Reconstructive Surgery | 1 E Delaware Pl, Suite 501, Chicago, IL 60611-1666 | |
| Mark I Golden | Ophthalmology | 875 N Michigan Ave, Suite 1550, Chicago, IL 60611-1886 | |
| Find all physicians in zip 60611 | |||
| City | CHICAGO |
| Zip Code | 60611 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CHICAGO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Krista Puckett.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.