Organization Active NPI

Blessings Community Care Clinic LLC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1548042716
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BLESSINGS COMMUNITY CARE CLINIC LLC
Practice address
200 E 75TH St Ste 200
Chicago, IL 60619-2280
Phone
(872) 231-4100
NPI assigned
Oct 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Tanya Wagner, FNP CNPI 1043091861
Title
Director
Phone
(872) 231-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

200 E 75TH St Ste 200
Chicago, IL 60619-2280

Mailing address

200 E 75TH St Ste 200
Chicago, IL 60619-2280
Phone (872) 231-4100

Other practice location 1

8950 S Cottage Grove Ave
Chicago, IL 60619-6932
Phone (872) 231-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240213004236 IL Part B Supplier - Clinic/Group Practice 1456795863 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2305303Blessings Community Care Clinic LLC200 E 75TH St - Ste 200, Chicago, IL 60619Certificate of waiverMay 28, 2028

National Provider Directory

National Provider Directory

Locations

200 E 75th St
Ste 200
Chicago, IL 60619
Phone (872) 231-4100

8950 S Cottage Grove Ave
Chicago, IL 60619
Phone (872) 231-4100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1548042716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 75TH ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606192280",
            "telephone_number": "872-231-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 75TH ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606192280",
            "telephone_number": "872-231-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8950 S Cottage Grove Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606196932",
            "country_code": "US",
            "telephone_number": "872-231-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLESSINGS COMMUNITY CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-20",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "872-231-4100",
        "authorized_official_credential": "FNP C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.