Tina Fruscione Blachut, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036128628 Issued in IL

Practice address

150 N River Rd Ste 310
Des Plaines, IL 60016-1272

Phone

(847) 795-0900

Fax

(847) 795-0955

NPI assigned

Jun 26, 2008

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 names 1

• Tina Josie Fruscione Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Suburban Family Medicine LTDGroup PAC ID 8022270412, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Holy Family Medical Center Long-term care hospital, Des Plaines, IL, CCN 142011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tblachut251533@direct.myadvocateaurora.org

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.

• North Suburban Family Medicine LTD

  • Family Medicine Physician
  • Des Plaines, IL
  • NPI 1104195809
  Medicare reassignment Care Compare group NPD

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

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Holy Family Medical Center - Des Plaines LLC

  • Long Term Care Hospital
  • Des Plaines, IL
  • NPI 1205674611

  Long-term care hospital

  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1174785588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD STE 310",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272",
            "telephone_number": "847-795-0900",
            "fax_number": "847-795-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD STE 310",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272",
            "telephone_number": "847-795-0900",
            "fax_number": "847-795-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACHUT",
        "first_name": "TINA",
        "middle_name": "FRUSCIONE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036128628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "FRUSCIONE",
            "middle_name": "JOSIE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adam Bixby, PHARMD
• BKD Personal Assistance Services LLC
• Tracey Latonya Blackburn
• Kathleen Leslie Blaha, LPC
• Kyle Cox Blair, DO
• Michael P Blair, M.D.
• Blare House Inc.

• Family Medicine Physician in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.