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CRYSTAL LAKE CLINIC
NPI 1124362306
Pediatrics - Pediatric Cardiology in Crystal Lake, IL

Active since November 12, 2012
360 STATION DR, CRYSTAL LAKE, IL 60014(815) 338-6600(815) 477-9826 Get Directions Write a Review

NPPES record last updated: November 12, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Crystal Lake Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL LAKE CLINIC (NPI 1124362306) is a healthcare organization registered as a pediatric cardiology in Crystal Lake, Illinois and active in the NPI registry since November 2012. The organization lists Smriti Khare, President, Children's Physician Grp, as its authorized official.

NPPES Registry Identity

NPI1124362306
Entity TypeOrganization
Primary Taxonomy2080P0202X
Legal Business NameCHILDREN'S PHYSICIAN GROUP
Location Address360 STATION DRCrystal Lake, IL 60014-7978
Mailing Address9000 W Wisconsin Ave, Ms 958Milwaukee, WI 53226-4874 · (414) 266-7615 · Fax (414) 266-6238
Phone(815) 338-6600
Fax(815) 477-9826
Organization SubpartYes
Authorized OfficialSmriti KharePresident, Children's Physician Grp · (414) 266-7615
Enumeration DateNovember 12, 2012
✔ NPI 1124362306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
360 STATION DR, Crystal Lake, IL 60014
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Other Names 1

Doing Business AsCrystal Lake Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA JAESCHKE CNP
Nurse Practitioner
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 338-6600
MRS. JENNA T WINSKO ANP-BC
Nurse Practitioner (Adult Health)
360 STATION DR, SUITE 120
CRYSTAL LAKE, IL 60014
McHenry County (815) 477-8900
MARIA JUANITA AVINA RN
Registered Nurse (Diabetes Educator)
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 356-2382
CHRISTOPHER M NORTHERN PA
Physician Assistant
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 356-2330
KATHLEEN L KRETCHMER R.N., C.D.E
Registered Nurse (Diabetes Educator)
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 338-6600
NIRAL B PATEL M.D.
Family Medicine
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 338-6600
YANBING LI M.D.
Family Medicine
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 338-6600
JASON A CARMAN DNP
Nurse Practitioner (Family)
360 STATION DR
CRYSTAL LAKE, IL 60014
McHenry County (815) 338-6600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Children's Physician Group's NPI number?

The NPI number for Children's Physician Group is 1124362306. It was assigned to this organization in the NPPES registry on November 12, 2012. The provider is doing business as Crystal Lake Clinic.

Where is Children's Physician Group located?

Children's Physician Group is located at 360 Station Dr, Crystal Lake, IL 60014. The listed phone number is (815) 338-6600.

What is Children's Physician Group's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

When was this NPI record last updated?

The NPPES record for Children's Physician Group was last updated on November 12, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.