Jose Eduardo Tirado, AGPCNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

0024175000 Issued in VA

Practice address

224 58TH St
Clarendon Hills, IL 60514-1712

Phone

(808) 225-4546

NPI assigned

Jun 29, 2017

Last updated

Jun 29, 2017By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1023539186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 58TH ST",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 58TH ST",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141712",
            "telephone_number": "808-225-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRADO",
        "first_name": "JOSE",
        "middle_name": "EDUARDO",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024175000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Clarendon Hills, IL
• Providers in Clarendon Hills, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.