Individual provider Active NPI

Tiffany Hartman

  • Nurse Practitioner
  • Bourbonnais, IL
National Provider Identifier
1194608927
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041-402210 Issued in IL
Practice address
6712 N Convent St
Bourbonnais, IL 60914-1528
Phone
(815) 928-8050
Fax
(815) 928-8932
NPI assigned
Jul 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041-402210 IL Primary

Addresses

Primary practice location

6712 N Convent St
Bourbonnais, IL 60914-1528

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

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
I20251104002796 IL Practitioner - Nurse Practitioner 9436649977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-7097

19552 S Harlem Ave
Frankfort, IL 60423-6733
Phone (815) 469-3453

2101 Waukegan Rd
Bannockburn, IL 60015-1836

350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671

500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2400

6712 N Convent St
Bourbonnais, IL 60914-1528
Phone (815) 928-8050

6850 Centennial Dr
Tinley Park, IL 60477-1653
Phone (815) 928-8050

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041-402210ILMDNurse Practitioner
209033620ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC CurrentSince Sep 25, 2025 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Sep 25, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

6712 N Convent St
Bourbonnais, IL 60914
Phone (815) 348-9500

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

19552 S Harlem Ave
Ofc
Frankfort, IL 60423

19552 S Harlem Ave
Bldg D
Frankfort, IL 60423
Phone (815) 469-3452

6850 Centennial Dr
Tinley Park, IL 60477
Phone (708) 429-3455

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1194608927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141528",
            "telephone_number": "815-928-8050",
            "fax_number": "815-928-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041-402210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.