Individual provider Active NPI

Twaniqua Maclin, FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1194387399
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.019722 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(312) 996-7420
Fax
(312) 413-8485
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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 209.019722 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

1740 W Taylor St
Chicago, IL 60612-7232
Phone (312) 966-7420

Other identifiers 1

IdentifierTypeStateIssuer
1194387399MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmaclin@uic.edu

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
I20201110002747 IL Practitioner - Nurse Practitioner 1254741820 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.019722ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Community Health Center CurrentSince Mar 7, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 10, 2025 Accepting new patients
Christian Community Health Center Current Accepting new patients

Locations

364 Torrence Ave
Calumet City, IL 60409
Phone (708) 868-9457

9718 S Halsted St
Chicago, IL 60628
Phone (773) 233-4100

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 3

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1194387399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-966-7420",
            "fax_number": "312-413-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-7420",
            "fax_number": "312-413-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLIN",
        "first_name": "TWANIQUA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194387399",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmaclin@uic.edu",
            "affiliation": "N",
            "address_1": "1740 W Taylor St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606127232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.