NPIMap

Individual provider Active NPI

Albert C Tanlim, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Watseka, IL
National Provider Identifier
1659342665
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
036091262 Issued in IL
Practice address
845 S 4TH St
Roberts Clinic LTD
Watseka, IL 60970-1628
Phone
(815) 432-2461
Fax
(815) 432-2535
NPI assigned
Jan 28, 2006
Last updated
Apr 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 036091262 IL Primary

Addresses

Primary practice location

845 S 4TH St
Roberts Clinic LTD
Watseka, IL 60970-1628

Mailing address

819 W Lafayette St
#93
Watseka, IL 60970
Phone (815) 432-4743

Other identifiers 5

IdentifierTypeStateIssuer
K10959OtherPIN
036091262MedicaidIL
200386800AMedicaidIN
03815080OtherILBC BS
3711693620021MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000401 IL Practitioner - Internal Medicine 3779543541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 E Orange St
Hoopeston, IL 60942-1801
Phone (217) 283-5531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Aug 30, 2012 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Aug 30, 2012 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Hoopeston Community Memorial Hospital Past Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1490 E Walnut St
Ste C
Watseka, IL 60970
Phone (815) 432-8200

845 S 4th St
Watseka, IL 60970
Phone (815) 432-2461

Organizations & group practices 5

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 10

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": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1659342665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 W LAFAYETTE ST",
            "address_2": "#93",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "60970",
            "telephone_number": "815-432-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S 4TH ST",
            "address_2": "ROBERTS CLINIC LTD",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701628",
            "telephone_number": "815-432-2461",
            "fax_number": "815-432-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANLIM",
        "first_name": "ALBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036091262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "K10959",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091262",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200386800A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "03815080",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3711693620021",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.