Individual provider Active NPI

Tiana Lynn Torres, D.C.

  • Chiropractor
  • Lake Villa, IL
National Provider Identifier
1205113198
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012055 Issued in IL
Practice address
36735 N Il Route 83 Ste D
Lake Villa, IL 60046-9621
Phone
(847) 265-5600
Fax
(847) 245-4491
NPI assigned
Nov 7, 2011
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012055 IL Primary

Addresses

Primary practice location

36735 N Il Route 83 Ste D
Lake Villa, IL 60046-9621

Mailing address

36735 N Il 83
Ste D
Lake Villa, IL 60046
Phone (478) 265-5600

Other identifiers 1

IdentifierTypeStateIssuer
1861894081OtherNPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130410000326 IL Practitioner - Chiropractic 4688810062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

36735 N Il Route 83
Suite D
Lake Villa, IL 60046-9621
Phone (847) 265-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012055ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
One Goal Wellness, Inc Chiropractor CurrentSince Mar 2, 2019 Accepting new patients

Locations

36735 N Il Route 83
Ste D
Lake Villa, IL 60046
Phone (847) 265-3340

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1205113198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36735 N IL 83",
            "address_2": "STE D",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "478-265-5600",
            "fax_number": "847-245-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36735 N IL ROUTE 83 STE D",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469621",
            "telephone_number": "847-265-5600",
            "fax_number": "847-245-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "TIANA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1861894081",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Villa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.