Individual provider Active NPI

Daisy Hariharan, NP

  • Family Nurse Practitioner
  • Woodridge, IL
National Provider Identifier
1487191425
Registry record updated Jan 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015499 Issued in IL
Practice address
2106 Aston Dr
Woodridge, IL 60517-8039
Phone
(847) 602-7422
NPI assigned
Jan 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041285576 IL
Family Nurse Practitioner 363LF0000X 209015499 IL Primary

Addresses

Primary practice location

2106 Aston Dr
Woodridge, IL 60517-8039

Mailing address

2106 Aston Dr
Woodridge, IL 60517-8039
Phone (630) 985-4699

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
I20170315000846 IL Practitioner - Nurse Practitioner 6204111289 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015499ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Family CurrentSince May 10, 2018 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1485648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485648000000",
    "number": "1487191425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 ASTON DR",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605178039",
            "telephone_number": "630-985-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 ASTON DR",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605178039",
            "telephone_number": "847-602-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIHARAN",
        "first_name": "DAISY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-29",
        "last_updated": "2017-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041285576",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

Verify at the official NPI Registry.