Provider Demographics
NPI:1508139023
Name:CRIBLEY, IRYNA (CRNP)
Entity Type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:CRIBLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:IRYNA
Other - Middle Name:
Other - Last Name:KYZYMYSHYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:19801 GOVERNORS HWY STE 160
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-4363
Mailing Address - Country:US
Mailing Address - Phone:708-957-0505
Mailing Address - Fax:708-957-4263
Practice Address - Street 1:19801 GOVERNORS HWY STE 160
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-4363
Practice Address - Country:US
Practice Address - Phone:708-957-0505
Practice Address - Fax:708-957-4263
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18108-NP363LF0000X
IN28239908A363LF0000X
PASP011970363LF0000X
IN71007715A363LF0000X
IL209.017053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ2920087OtherMEDICARE PTAN