Miriam Tamara Derman, RN, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

198.000716 Issued in IL

Practice address

2530 Crawford Ave Ste 108
Evanston, IL 60201-4954

Phone

(847) 323-2002

NPI assigned

Nov 7, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1427202175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 108",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014954",
            "telephone_number": "847-323-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 108",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014954",
            "telephone_number": "847-323-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMAN",
        "first_name": "MIRIAM",
        "middle_name": "TAMARA",
        "credential": "RN, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-208828",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198.000716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Denton, LCSW
• Courtney Elizabeth Depa, RDN
• Virginia M Depaul
• Allison Honart West Depersia, MD
• Gregory Derk, DPM
• Matthew Derrick, MD
• Jessica Desa
• Shiv D Desai, DO
• Mark A Deshur, M.D.
• Brielle Desimone, LMFT

• Acupuncturist in Evanston, IL
• Providers in Evanston, IL by specialty
• Acupuncturist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.