Individual provider Active NPI

Marion Tan, DNP

  • Adult Health Nurse Practitioner
  • Long Grove, IL
National Provider Identifier
1427666304
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209025913 Issued in IL
Practice address
3880 Salem Lake Dr Ste F
Long Grove, IL 60047-5292
Phone
(847) 719-2220
Fax
(847) 719-2265
NPI assigned
Jul 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.456357 IL
Family Nurse Practitioner 363LF0000X 209.025913 IL
Adult Health Nurse Practitioner 363LA2200X 209025913 IL Primary

Addresses

Primary practice location

3880 Salem Lake Dr Ste F
Long Grove, IL 60047-5292

Mailing address

3880 Salem Lake Dr Ste F
Long Grove, IL 60047-5292
Phone (847) 719-2220

Other identifiers 2

IdentifierTypeStateIssuer
209025913MedicaidIL
MT8489785OtherILDEA

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
I20220609000549 IL Practitioner - Nurse Practitioner 5991183600 Reassigns benefits to 2 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

Practice addresses (Care Compare)

3880 Salem Lake Dr
Suite F
Long Grove, IL 60047-5292
Phone (847) 719-2220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.456357ILMDRegistered Nurse
209.025913ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Best Practices Inpatient Care, LTD. Current Accepting new patients
Best Practices Inpatient Care, LTD. CurrentSince Aug 15, 2024 Accepting new patients
Best Practices Inpatient Care,LTD CurrentSince Aug 15, 2024 Accepting new patients
Access Community Health Network Current Accepting new patients
Access Community Health Network CurrentSince Jun 13, 2022 Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

106 Barrington Commons Ct
Unit 1790
Barrington, IL 60011
Phone (847) 719-2220

245 S Gary Ave
Ste 200
Bloomingdale, IL 60108
Phone (630) 893-5230

245 S Gary Ave
#T
Bloomingdale, IL 60108
Phone (630) 893-5230

245 S Gary Ave
Bloomingdale, IL 60108
Phone (630) 305-6301

3880 Salem Lake Dr
Ste F
Long Grove, IL 60047
Phone (847) 719-2220

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Organizations & group practices 5

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1427666304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 SALEM LAKE DR STE F",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475292",
            "telephone_number": "847-719-2220",
            "fax_number": "847-719-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SALEM LAKE DR STE F",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475292",
            "telephone_number": "847-719-2220",
            "fax_number": "847-719-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MARION",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.456357",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025913",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209025913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209025913",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEA",
            "identifier": "MT8489785",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

Verify at the official NPI Registry.