Bridget Elizabeth Tyner Saroya, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Chicago, IL
NPI 1144200056 · NPPES record last updated Jun 29, 2016
Key facts
- NPI
- 1144200056
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- RN305998 NP08460 (OH)
- Practice address
- 1044 N Mozart St
Ste-402
Chicago, IL 60622-2789 - Phone
- (773) 292-4501
- Fax
- (773) 292-2613
- NPI assigned
- Jan 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209013607 | IL | MD | Pediatric Nurse Practitioner |
| RN305998 NP08460 | OH | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Pediatrics PLLC | Past |
Accepting new patients | |
| Lebanon Special School District | Past | Accepting new patients | |
| Cumberland County Board of Education | Past | Accepting new patients | |
| Grace Pediatrics PLLC | Pediatrics | Past | Accepting new patients |
| Sumner County Board of Education | Past | Accepting new patients | |
| McNairy County Schools | Past | Accepting new patients |
Interoperability endpoints
- bridget.saroya.1@31800.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN305998 NP08460 | OH | Yes |
| Pediatric Nurse Practitioner | 363LP0200X | 209013607 | IL |
Addresses
Primary practice location
1044 N Mozart St
Ste-402
Chicago, IL 60622-2789
Mailing address
1044 N Mozart St
Ste-402
Chicago, IL 60622-2789
Phone (773) 292-4501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2611598 | Medicaid | OH |
Other providers in Chicago, IL
- David H. Sarne
- Elissa Louise Sarno
- Jana Maria Sarno
- Saroj K Verma MD SC
- Saroj K. Verma
- Philip Sarpong-Mensah
- Alex Sarpong
- Kofi Sarpong
- Rachel Sarpong
- Paya Tavakoli Sarraf
All providers in Chicago, IL · Pediatric Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.