Individual provider Active NPI

Roseann Tanquilut, NURSE PRACTITIONER

  • Nurse Practitioner
  • Arlington Heights, IL
National Provider Identifier
1568112589
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209024954 Issued in IL
Practice address
880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2355
Phone
(847) 618-3800
Fax
(847) 618-3809
NPI assigned
Mar 24, 2022
Last updated
May 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209024954 IL Primary
Family Nurse Practitioner 363LF0000X 209024954 IL

Addresses

Primary practice location

880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2355

Mailing address

880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2355
Phone (847) 618-3800

Other identifiers 1

IdentifierTypeStateIssuer
209024954OtherILSTATE LICENSE

Other names 1

  • Roseann Melo Perez Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rperez131566@direct.nch.org

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
I20220601000806 IL Practitioner - Nurse Practitioner 3476931635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

880 W Central Rd
Arlington Heights, IL 60005-2355
Phone (847) 483-9400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209024954ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Community Health Services Inc Nurse Practitioner CurrentSince May 23, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 30, 2023 Accepting new patients
Northwest Community Health Services Inc CurrentSince May 23, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 30, 2023 Accepting new patients

Locations

3040 W Salt Creek Ln
Arlington Heights, IL 60005
Phone (847) 618-3481

880 W Central Rd
Ste 5000
Arlington Heights, IL 60005
Phone (847) 618-3800

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

880 W Central Rd
Arlington Hts, IL 60005
Phone (847) 394-3553

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

25233 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: rperez131566@direct.nch.org

Organizations & group practices 4

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.

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1568112589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANQUILUT",
        "first_name": "ROSEANN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024954",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024954",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209024954",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rperez131566@direct.nch.org",
            "affiliation": "N",
            "address_1": "880 W Central Rd Ste 5000",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600052355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROSEANN",
            "last_name": "PEREZ",
            "middle_name": "MELO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.