Individual provider Active NPI

Tanner Craig Eiben, DO

  • Family Medicine Physician
  • Quincy, IL
National Provider Identifier
1710472964
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.073359 Issued in IL
Practice address
612 N 11TH St
Quincy, IL 62301-2662
Phone
(217) 224-9484
Fax
(217) 224-7950
NPI assigned
Jun 28, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 125.073359 IL
Family Medicine Physician 207Q00000X 125.073359 IL Primary

Addresses

Primary practice location

612 N 11TH St
Quincy, IL 62301-2662

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address teiben45447@blessing.medalliesdirect.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823001483 IL Practitioner - Family PracticePractitioner - Sports Medicine 5597012393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Kansas City College of Medicine and Surgery, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

4800 Maine St
Quincy, IL 62305-5875
Phone (217) 224-6423

612 N 11TH St
Quincy, IL 62301-2662
Phone (217) 224-9484

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.073359ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siuphysicians & Surgeons, Inc. Current Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Blessing Hospital CurrentSince Oct 1, 2022 Accepting new patients
Board of Trustees of Southern Illinois University Family Medicine CurrentSince Aug 8, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 8, 2022 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Blessing Hospital CurrentSince Oct 1, 2022 Accepting new patients
Southern Illinois University Past Accepting new patients
Blessing Hospital Past Accepting new patients

Locations

4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444

1005 Broadway St
Quincy, IL 62301

612 N 11th St
Quincy, IL 62301
Phone (217) 224-9484

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • Direct secure messaging: tannereiben@siu.allscriptsdirect.net

Organizations & group practices 9

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 2

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1710472964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484",
            "fax_number": "217-224-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIBEN",
        "first_name": "TANNER",
        "middle_name": "CRAIG",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "125.073359",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.073359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teiben45447@blessing.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4800 Maine St",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623055875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.