Individual provider Active NPI

Tamisha Antonia Novak, APN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1336851997
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209026398 Issued in IL
Practice address
5758 S Maryland Ave Suite 5a
Chicago, IL 60637
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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 209026398 IL Primary

Addresses

Primary practice location

5758 S Maryland Ave Suite 5a
Chicago, IL 60637

Mailing address

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-6138

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
I20230330001669 IL Practitioner - Nurse Practitioner 8224402417 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians
The University of Chicago Medical CenterGroup PAC ID 7618880766, 907 clinicians

Practice addresses (Care Compare)

47 W Polk St
Suite G1
Chicago, IL 60605-2083
Phone (888) 824-0200

5400 W 87TH St
Burbank, IL 60459-2913
Phone (708) 423-1200

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

Hospital & facility affiliations

  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209026398ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Chicago CurrentSince Feb 23, 2023 Accepting new patients
CMC Healthcare LLC CurrentSince Dec 13, 2024 Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 23, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 23, 2023 Accepting new patients

Locations

5400 W 87th St
Burbank, IL 60459
Phone (708) 346-6236

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

5758 S Maryland Ave
Ste 5A
Chicago, IL 60637
Phone (773) 702-6138

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: tnovak191259@uchospital.direct-ci.com

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 1

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1336851997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5758 S MARYLAND AVE SUITE 5A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "TAMISHA",
        "middle_name": "ANTONIA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.