Individual provider Active NPI

Tanique Parker, APRN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1013744580
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030579 Issued in IL
Practice address
1520 N Damen Ave
Chicago, IL 60622-1967
Phone
(312) 283-5560
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209030579 IL Primary

Addresses

Primary practice location

1520 N Damen Ave
Chicago, IL 60622-1967

Mailing address

1520 N Damen Ave
Chicago, IL 60622-1967
Phone (312) 283-5560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031002523 IL Practitioner - Nurse Practitioner 0840723607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, Inc 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209030579ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Sep 26, 2024 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Sep 26, 2024 Accepting new patients

Locations

219 W Chicago Ave
Chicago, IL 60654
Phone (312) 878-1945

1520 N Damen Ave
Chicago, IL 60622
Phone (312) 278-5955

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1013744580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221967",
            "telephone_number": "312-283-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221967",
            "telephone_number": "312-283-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "TANIQUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.