Individual provider Active NPI

Nicole Ann Tymann, APN

  • Nurse Practitioner
  • Bloomingdale, IL
National Provider Identifier
1528608577
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020840 Issued in IL
Practice address
220 Springfield Dr Ste 100
Bloomingdale, IL 60108-2215
Phone
(888) 693-6437
Fax
(630) 946-2363
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209020840 IL Primary

Addresses

Primary practice location

220 Springfield Dr Ste 100
Bloomingdale, IL 60108-2215

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ntymann246434@dulyhealthandcare.direct-ci.com Direct

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
I20200304002151 IL Practitioner - Nurse Practitioner 3375970379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1222

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone (847) 437-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209020840ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Current Accepting new patients
Dupage Medical Group LTD CurrentSince Apr 4, 2022 Accepting new patients
Cep America - Illinois, LLP CurrentSince Aug 1, 2020 Accepting new patients
Dupage Medical Group LTD CurrentSince Apr 4, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

220 Springfield Dr
Ste 100
Bloomingdale, IL 60108

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

25 N Winfield Rd
Ste 300
Winfield, IL 60190
Phone (630) 933-8100

Interoperability endpoints

  • Direct secure messaging: ntymann246434@dulyhealthandcare.direct-ci.com

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 2

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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1528608577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SPRINGFIELD DR STE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082215",
            "telephone_number": "888-693-6437",
            "fax_number": "630-946-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMANN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntymann246434@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "220 Springfield Dr Ste 100",
            "city": "Bloomingdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601082215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.