Individual provider Active NPI

Tristan Talua, NP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1508239963
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209013568 Issued in IL
Practice address
840 W Irving Park Rd Ste 301
Chicago, IL 60613-3011
Phone
(773) 975-3269
Fax
(773) 975-3270
NPI assigned
Nov 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209013568 IL Primary

Addresses

Primary practice location

840 W Irving Park Rd Ste 301
Chicago, IL 60613-3011

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

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
I20160412002750 IL Practitioner - Nurse Practitioner 6103124854 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209013568ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Post Acute Care PLLC CurrentSince Mar 29, 2016 Accepting new patients
Midwest Post Acute Care Aco PLLC CurrentSince Sep 1, 2024 Accepting new patients
Sound Physicians of Illinois, LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

311 Edgewater Dr
Bloomingdale, IL 60108
Phone (630) 894-7400

716 18th St
Charleston, IL 61920
Phone (217) 345-7054

840 W Irving Park Rd
Ste 301
Chicago, IL 60613
Phone (773) 447-0200

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1 Park Ln W
Clinton, IL 61727
Phone (217) 935-8500

Organizations & group practices 3

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": "1446854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1508239963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "773-975-3269",
            "fax_number": "773-975-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALUA",
        "first_name": "TRISTAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-07",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.