Provider Demographics
NPI:1760284038
Name:KOSTRYBA, KHRYSTYNA (APRN, FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:KHRYSTYNA
Middle Name:
Last Name:KOSTRYBA
Suffix:
Gender:F
Credentials:APRN, FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST FL 14
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2987
Mailing Address - Country:US
Mailing Address - Phone:312-695-7746
Mailing Address - Fax:312-926-6600
Practice Address - Street 1:259 E ERIE ST FL 14
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2987
Practice Address - Country:US
Practice Address - Phone:312-695-7746
Practice Address - Fax:312-926-6600
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.485301163W00000X
IL209032093363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse