Ticonna D Purdle, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009555 Issued in IL

Practice address

7325 S Exchange Ave
Chicago, IL 60649-3407

Phone

(773) 731-7300

NPI assigned

Oct 2, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eon Care Clinicians PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1073332490
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1013268903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21333 HAGGERTY RD",
            "address_2": "SUITE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755510",
            "telephone_number": "248-662-0250",
            "fax_number": "248-662-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493407",
            "telephone_number": "773-731-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDLE",
        "first_name": "TICONNA",
        "middle_name": "D",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyam Puppala, MD
• John David Purakal, M.D., M.S.
• Caitlin Purcell
• Michael J Purcell, PSYD
• Sierra Purcell, PA
• Pure Balance Psychotherapy PLLC
• Pure Bodyworks
• Pure Health Center, Inc
• Pure Hearts Home Health Services Inc.
• Pure Light Healthcare LLC

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.