Individual provider Active NPI

Tiffany Delane, PA-C

  • Medical Physician Assistant
  • Naperville, IL
National Provider Identifier
1255311502
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-001946 Issued in IL
Practice address
4003 S RT 59
Naperville, IL 60564-1504
Phone
(888) 693-6437
NPI assigned
Jan 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-001946 IL Primary

Addresses

Primary practice location

4003 S RT 59
Naperville, IL 60564-1504

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tdelane185745@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-001946ILMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1255311502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 S RT 59",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605641504",
            "telephone_number": "888-693-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANE",
        "first_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-001946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdelane185745@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "4003 S Rt 59",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605641504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.