Individual provider Active NPI

TSZ Fan Tse

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1104480995
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018166 Issued in IL
Practice address
2142 S Archer Ave
Chicago, IL 60616-1514
Phone
(312) 326-1400
Fax
(312) 326-4188
NPI assigned
Apr 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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 209018166 IL Primary

Addresses

Primary practice location

2142 S Archer Ave
Chicago, IL 60616-1514

Mailing address

2142 S Archer Ave
Chicago, IL 60616-1514
Phone (312) 326-1400

Other names 1

  • Kaitlyn Tse Other name

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
I20190529000535 IL Practitioner - Nurse Practitioner 0749523124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 250
Chicago, IL 60612-3861
Phone (312) 942-6163

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Dec 9, 2024 Accepting new patients
Thorek Memorial Hospital CurrentSince Apr 23, 2019 Accepting new patients
Rush University Medical Center CurrentSince Dec 9, 2024 Accepting new patients
Thorek Memorial Hospital CurrentSince Apr 23, 2019 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2142 S Archer Ave
Chicago, IL 60616
Phone (312) 326-1400

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 250
Chicago, IL 60612
Phone (312) 942-6163

1725 W Harrison St
Ste 207
Chicago, IL 60612

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1104480995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161514",
            "telephone_number": "312-326-1400",
            "fax_number": "312-326-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161514",
            "telephone_number": "312-326-1400",
            "fax_number": "312-326-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSE",
        "first_name": "TSZ FAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "TSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.