Active NPI
Tarissa La Shell Stanciel, RN
- Maternal Newborn Registered Nurse
- Bellwood, IL
National Provider Identifier
1699314310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal Newborn Registered Nurse
- License
- 041300689
- Practice address
- 932 23Rd Ave
Bellwood, IL 60104-2501 - Phone
- (708) 426-8293
- NPI assigned
- Dec 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal Newborn Registered Nurse | 163WM0102X | 041300689 | IL | Primary |
Addresses
Primary practice location
932 23Rd Ave
Bellwood, IL 60104-2501
Mailing address
932 23Rd Ave
Bellwood, IL 60104-2501
Phone (708) 632-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041300689 | IL | MD | Maternal Newborn Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577491200000",
"number": "1699314310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 23RD AVE",
"city": "BELLWOOD",
"state": "IL",
"postal_code": "601042501",
"telephone_number": "708-632-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 23RD AVE",
"city": "BELLWOOD",
"state": "IL",
"postal_code": "601042501",
"telephone_number": "708-426-8293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANCIEL",
"first_name": "TARISSA",
"middle_name": "LA SHELL",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-28",
"last_updated": "2019-12-28",
"certification_date": "2019-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0102X",
"taxonomy_group": "",
"desc": "Registered Nurse, Maternal Newborn",
"state": "IL",
"license": "041300689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.