Individual provider Active NPI

Lana Tymouch, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1609818996
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001905 Issued in IL
Practice address
850 S Wabash Ave
Ste 301
Chicago, IL 60605-3641
Phone
(312) 583-1066
Fax
(312) 583-1897
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001905 IL Primary

Addresses

Primary practice location

850 S Wabash Ave
Ste 301
Chicago, IL 60605-3641

Mailing address

850 S Wabash Ave
Ste 301
Chicago, IL 60605-3641
Phone (312) 583-1066

Other names 1

  • Mrs. Svitlana Tymouch Other name

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
I20120525000037 IL Practitioner - Physician Assistant 4284897414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thorek Memorial HospitalGroup PAC ID 4981593399, 49 clinicians

Practice addresses (Care Compare)

2515 W Chicago Ave
Chicago, IL 60622-4516
Phone (312) 583-1066

850 W Irving Park Rd
Chicago, IL 60613-3077

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.04 of 100Reported as group
Quality
53.2
Promoting interoperability
89
Improvement activities
40
Cost
76.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thorek Memorial Hospital CurrentSince Jan 16, 2017 Accepting new patients
Thorek Radiology Group NFP Current Accepting new patients

Locations

840 W Irving Park Rd
Ste 301
Chicago, IL 60613
Phone (773) 447-0200

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1609818996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE",
            "address_2": "STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053641",
            "telephone_number": "312-583-1066",
            "fax_number": "312-583-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE",
            "address_2": "STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053641",
            "telephone_number": "312-583-1066",
            "fax_number": "312-583-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMOUCH",
        "first_name": "LANA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SVITLANA",
            "last_name": "TYMOUCH",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.