Jonathan Bautista Tanawan, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

036.170234 Issued in IL

Practice address

1969 W Ogden Ave
Chicago, IL 60612-3765

Phone

(312) 864-0516

Fax

(312) 491-5020

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtanawan167546@uihealth.direct-ci.com

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.

• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Primecare Community Health, Inc.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1558532739
  Medicare reassignment NPD
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170

  Family Medicine

  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• Primecare Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1891541215
  NPD
• Primecare Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1225010911

  Family Medicine

  NPD
• Primecare Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1871117937
  NPD (past)

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1609443571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221774",
            "telephone_number": "312-633-5841",
            "fax_number": "312-491-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123765",
            "telephone_number": "312-864-0516",
            "fax_number": "312-491-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAWAN",
        "first_name": "JONATHAN",
        "middle_name": "BAUTISTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.170234",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036.170234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Quanbee Tan, MD
• Wendy Tan
• Zhong Zi Tan
• Shun Tanaka
• Emma Tanase, MD
• Helen Stacy Tanchez
• Mark Tancredi, M.D.
• Tandem Psychology LLC
• Ely Robert Tandeter
• Cornelia Yillasan Tandez, MD

• Addiction Medicine (Family Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Addiction Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.