Individual provider Active NPI

Tammy Chavarria

  • Nurse Practitioner
  • Oakbrook Terrace, IL
National Provider Identifier
1043677529
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209005920 Issued in IL
Practice address
2 Transam Plaza Dr Ste 400
Oakbrook Terrace, IL 60181-4808
Phone
(630) 545-3766
Fax
(630) 933-7392
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 041303804 IL
Ambulatory Women's Health Care Registered Nurse 163WW0101X 28172884A IN
Women's Health Nurse Practitioner 363LW0102X 71002390A IN
Women's Health Nurse Practitioner 363LW0102X 209005920 IL
Nurse Practitioner 363L00000X 209005920 IL Primary

Addresses

Primary practice location

2 Transam Plaza Dr Ste 400
Oakbrook Terrace, IL 60181-4808

Mailing address

2 Transam Plaza Dr Ste 400
Oakbrook Terrace, IL 60181-4808
Phone (630) 545-3766

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
I20201103000509 IL Practitioner - Nurse Practitioner 8628488616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Transam Plaza Dr
Suite 400
Oakbrook Terrace, IL 60181-4808
Phone (630) 545-3766

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041303804ILMDAmbulatory Women's Health Care Registered Nurse
28172884AINMDAmbulatory Women's Health Care Registered Nurse
209005920ILMDNurse Practitioner
71002390AINMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 17, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 17, 2020 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2 Transam Plaza Dr
Ste 400
Oakbrook Terrace, IL 60181
Phone (630) 545-3766

Organizations & group practices 3

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1043677529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TRANSAM PLAZA DR STE 400",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814808",
            "telephone_number": "630-545-3766",
            "fax_number": "630-933-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TRANSAM PLAZA DR STE 400",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814808",
            "telephone_number": "630-545-3766",
            "fax_number": "630-933-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVARRIA",
        "first_name": "TAMMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "IL",
            "license": "041303804",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "IN",
            "license": "28172884A",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "71002390A",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209005920",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.