Individual provider Active NPI

Tierra Williams

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1144977935
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209024848 Issued in IL
Practice address
2450 N Central Ave
Chicago, IL 60639-1316
Phone
(773) 889-1333
Fax
(847) 221-6942
NPI assigned
Mar 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 209024848 IL
Adult Health Nurse Practitioner 363LA2200X 209024848 IL Primary

Addresses

Primary practice location

2450 N Central Ave
Chicago, IL 60639-1316

Mailing address

1025 Charlela LN Apt 305
Elk Grove Village, IL 60007-3258
Phone (309) 807-6769

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
I20220420001398 IL Practitioner - Nurse Practitioner 6709273840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

2450 N Central Ave
Chicago, IL 60639-1316
Phone (773) 889-1333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209024848ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC CurrentSince May 20, 2024 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

2450 N Central Ave
Chicago, IL 60639
Phone (773) 889-1333

50 N Jane Dr
Elgin, IL 60123
Phone (815) 844-2610

6631 N Milwaukee Ave
Niles, IL 60714
Phone (847) 588-4131

3450 Oakton St
Ste 300
Skokie, IL 60076

Organizations & group practices 1

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1144977935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 CHARLELA LN APT 305",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073258",
            "telephone_number": "309-807-6769",
            "fax_number": "847-221-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391316",
            "telephone_number": "773-889-1333",
            "fax_number": "847-221-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209024848",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209024848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.