Individual provider Active NPI

Tiffany Marie Migon, APN

  • Family Nurse Practitioner
  • Burr Ridge, IL
National Provider Identifier
1609225358
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.014252 Issued in IL
Practice address
6101 S County Line Rd
Burr Ridge, IL 60527-8132
Phone
(630) 686-9000
Fax
(844) 235-2578
NPI assigned
Jun 3, 2016
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
Family Nurse Practitioner 363LF0000X 209.014252 IL Primary

Addresses

Primary practice location

6101 S County Line Rd
Burr Ridge, IL 60527-8132

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmigon170086@dulyhealthandcare.direct-ci.com

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
I20160705001017 IL Practitioner - Nurse Practitioner 2365734746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians
Residential Hospice Illinois LLCGroup PAC ID 4486800109, 4 clinicians

Practice addresses (Care Compare)

200 Martin Ave
Naperville, IL 60540-6516
Phone (630) 355-4111

2443 Warrenville Rd
Suite 500
Lisle, IL 60532-4356
Phone (855) 902-5100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.014252ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Healthcare LLC CurrentSince Jan 2, 2025 Accepting new patients
Kohli & Khan Internists MD SC PastSince Jun 30, 2016 Accepting new patients

Locations

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

200 Martin Ave
Naperville, IL 60540
Phone (630) 236-8018

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1609225358",
    "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": "6101 S COUNTY LINE RD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278132",
            "telephone_number": "630-686-9000",
            "fax_number": "844-235-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIGON",
        "first_name": "TIFFANY",
        "middle_name": "MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmigon170086@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "6101 S County Line Rd",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605278132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.