Stephanie Tanwangco, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.026111 Issued in IL

Practice address

50 Northgate Industrial Dr
Granite City, IL 62040-6805

Phone

(618) 877-4420

NPI assigned

Oct 5, 2022

Last updated

Dec 13, 2022By the provider in NPPES

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

May accept Medicare assignment

Group practices

Chestnut Health Systems IncGroup PAC ID 1052393063, 31 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chestnut Health Systems Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bloomington, IL
  • NPI 1366431686
  Medicare reassignment Care Compare group NPD
• Wellnow Urgent Care, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  IL

  Medicare reassignment
• Chestnut Health Systems Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wood River, IL
  • NPI 1235941311
  NPD
• Chestnut Health Systems, Inc

  dba Chestnut Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Bloomington, IL
  • NPI 1790055952
  NPD (past)

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1548985203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 WYLIE DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615405",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORTHGATE INDUSTRIAL DR",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406805",
            "telephone_number": "618-877-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13448 Cicero Ave",
            "address_purpose": "LOCATION",
            "city": "Crestwood",
            "state": "IL",
            "postal_code": "604181430",
            "country_code": "US",
            "telephone_number": "708-682-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANWANGCO",
        "first_name": "STEPHANIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.026111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Lynn Sutton, RN
• Sheila Swist-Schleeper, PHARMD
• Julienne Carol Szlufik, APN
• Talley Chiropractic, PC
• Jason R Talley, DC
• Jessica Marie Taul, PT, DPT
• John Richard Taylor III, PTA
• Taylorville Chiropractic Clinic LTD. (Spinal Care Center)
• Noah Matthew Tennyson, PHARM.D.
• The Hope Clinic for Women, LTD

• Family Nurse Practitioner in Granite City, IL
• Providers in Granite City, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.