Tania Diaz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

241 Commerce Dr Ste 102
Crystal Lake, IL 60014-3538

Phone

(815) 524-2200

NPI assigned

Mar 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIHEBA
• FHIR API: https://fhir4.healow.com/fhir/r4/ECGEBD

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.

• Favia Primary Care, SC

  • Family Medicine Physician
  • Algonquin, IL
  • NPI 1669964300
  Medicare reassignment
• Northwest Pulmonary and Sleep Medicine SC

  • Legal Medicine
  • Algonquin, IL
  • NPI 1881878221
  NPD (past)

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1366070955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 COMMERCE DR STE 102",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 COMMERCE DR STE 102",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143538",
            "telephone_number": "815-524-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Ryan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601024527",
            "country_code": "US",
            "telephone_number": "815-276-0150",
            "fax_number": "877-461-6742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "TANIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Lynn Derose, APN
• Nikul Desai, DPT
• Ali M Dia, D.C.
• Diabetic Footwear Solutuions LLC
• Amanda Marie Diamond, PA-C
• Tara Dickel, RPH
• William E Dickson
• Krista Diehl
• Brooklyn Camille Diemer
• Jennifer Joann Dienelt

• Physician Assistant in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.