Tanya Tanzillo, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209005985 Issued in IL

Practice address

2507 N Richmond Rd
McHenry, IL 60051

Phone

(815) 338-6600

Fax

(815) 759-4078

NPI assigned

Aug 20, 2006

Last updated

Oct 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 13, 2026 through May 13, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Wholehealth Chicago-3

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1487722666
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1114032802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 N RICHMOND RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600515407",
            "telephone_number": "815-338-6600",
            "fax_number": "815-759-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 N RICHMOND RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60051",
            "telephone_number": "815-338-6600",
            "fax_number": "815-759-4078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Station Drive",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "60014",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 Haligus Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429585",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANZILLO",
        "first_name": "TANYA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005985",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209005985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209005985",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Ivette Taborn
• Rachel Tack, LCSW
• Muhammad Hammad Tahir, M.D.
• Chanzo Tambuzi
• Charles J Tannenbaum, DDS
• Erika Tapia
• Juan Tapia
• Yazmin Tapia
• Target Corporation (Target Pharmacy)
• Amna Tariq

• Family Nurse Practitioner in McHenry, IL
• Providers in McHenry, 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 22, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.