Mary Taccona, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209026634 Issued in IL

Practice address

1189 N Gary Ave
Carol Stream, IL 60188-9423

Phone

(630) 517-5674

NPI assigned

Aug 29, 2023

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

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.

• Bodyworks Medical Center PLLC

  • General Practice Physician
  • Carol Stream, IL
  • NPI 1144700105
  Medicare reassignment NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1467237354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 LONGRIDGE DR",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081416",
            "telephone_number": "630-991-7943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601889423",
            "telephone_number": "630-517-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACCONA",
        "first_name": "MARY",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John E Sullivan, D.D.S.
• Hiral Suthar
• Linda M Svazas, RPH
• Abdulaziz Syed, LCSW
• Symphony Medical Group PC
• Raymundo Bernardo Tad-Y Jr., LCPC, NCE, NCSC
• Nicole Jean Talsma, MS
• Douglas Tansor Jr., D.C.
• Brandon Mitchell Taylor, D.C.
• Justin Michael Taylor, D.C.

• Family Nurse Practitioner in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.