Taniyamol Joseph, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209019253 Issued in IL

Practice address

2504 Washington St Ste 102
Waukegan, IL 60085-4960

Phone

(847) 623-7590

NPI assigned

Aug 27, 2019

Last updated

Apr 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integra Healthcare SCGroup PAC ID 0042539173, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Integra Healthcare SC

  • Internal Medicine Physician
  • Waukegan, IL
  • NPI 1083000350
  Medicare reassignment Care Compare group NPD
• Chestnut Health of Illinois LLC

  • Internal Medicine Physician
  • Elgin, IL
  • NPI 1588043939
  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  IL

  Medicare reassignment NPD
• Central Dupage Physical Medicine LT

  • Physical Medicine & Rehabilitation Physician
  • Carol Stream, IL
  • NPI 1528117090
  NPD (past)
• Fkleung, MD, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Waukegan, IL
  • NPI 1205159076
  NPD (past)

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1760030498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8995 KENNEDY DR APT 1F",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165400",
            "telephone_number": "224-616-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST STE 102",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854960",
            "telephone_number": "847-623-7590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8995 Kennedy Dr Apt 1F",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600165400",
            "country_code": "US",
            "telephone_number": "224-616-0485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "TANIYAMOL",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Joseph, BA
• Ben Joseph
• George Joseph, PHARMD
• Reny Joseph, MD
• Stephen Joseph
• Tijo Joseph
• Joe Marshall Jowers
• Kimberly Juarez
• Daniel Jeremy Juliana
• Helen Jung

• Nurse Practitioner in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.