Tiesha Riann Panek, PMHNP-BC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

209026792 Issued in IL

Practice address

10 W Main St Ste 101
Cary, IL 60013-2868

Phone

(815) 526-3781

NPI assigned

Feb 9, 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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main St Psychiatry SCGroup PAC ID 0648535013, 2 clinicians

Practice addresses (Care Compare)

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.

• Main St. Psychiatry, S.C.

  • Psychiatry Physician
  • Cary, IL
  • NPI 1346756491
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1477250595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 THOMPSON RD",
            "city": "WONDER LAKE",
            "state": "IL",
            "postal_code": "600978242",
            "telephone_number": "815-276-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W MAIN ST STE 101",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132868",
            "telephone_number": "815-526-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANEK",
        "first_name": "TIESHA",
        "middle_name": "RIANN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "209026792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Pediatric Therapy
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• Blake An Han Tong Palliser, DMD
• Paul Allen Palliser, D.D.S.
• Kenneth William Park, D.O.
• Niraj J Patel, DDS
• Rimpal N Patel
• Pathway Dietetics LLC
• Paul a. Palliser, D.D.S., P.C.

• Psychiatry Physician in Cary, IL
• Providers in Cary, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.