Individual provider Active NPI

Tiffani Henn, APRN, FNP-C

  • Family Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1255115838
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.027821 Issued in IL
Practice address
875 S Route 31
Crystal Lake, IL 60014-8190
Phone
(779) 220-5500
NPI assigned
Aug 23, 2023
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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 209.027821 IL Primary

Addresses

Primary practice location

875 S Route 31
Crystal Lake, IL 60014-8190

Mailing address

29624 Network PL
Chicago, IL 60673-1296
Phone (608) 756-6278

Other practice location 1

2650 Ridge Ave
Evanston, IL 60201-1781
Phone (847) 570-2000

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
I20231023001626 IL Practitioner - Nurse Practitioner 7416303797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.027821ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Sep 7, 2023 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Mercy Health System Corporation CurrentSince May 5, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince May 5, 2025 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

9532 Eagle Way
Chicago, IL 60678

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

901 Grant St
Harvard, IL 60033
Phone (815) 943-2961

Interoperability endpoints

  • Direct secure messaging: thenn124201@direct.mhemail.org

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

Hospital & facility affiliations 2

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": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1255115838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29624 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731296",
            "telephone_number": "608-756-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S ROUTE 31",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600148190",
            "telephone_number": "779-220-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011781",
            "country_code": "US",
            "telephone_number": "847-570-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENN",
        "first_name": "TIFFANI",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.