NPIMap

Individual provider Active NPI

Manish Tanna, MD

  • Nephrology Physician
  • Mount Prospect, IL
National Provider Identifier
1821096470
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036096147 Issued in IL
Practice address
601 W Golf Rd Ste 105
Mount Prospect, IL 60056-4276
Phone
(847) 439-8780
Fax
(847) 439-8940
NPI assigned
Jul 8, 2005
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036096147 IL Primary

Addresses

Primary practice location

601 W Golf Rd Ste 105
Mount Prospect, IL 60056-4276

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other identifiers 2

IdentifierTypeStateIssuer
036096147MedicaidIL
1616108OtherILBCBS

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mtanna252212@direct.myadvocateaurora.org Direct
Direct Messaging Address credentialing@nephdocs.com Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20031209000845 IL Practitioner - NephrologyPractitioner - Internal Medicine 3476459603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

601 W Golf Rd
Suite 105
Mount Prospect, IL 60056-4276
Phone (847) 439-8780

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Illinois, LTD. Nephrology CurrentSince May 11, 2017 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. Nephrology CurrentSince May 11, 2017 Accepting new patients
Nephrology Associates of Northern Indiana, Inc Nephrology PastSince Aug 1, 2024 Accepting new patients
Nani Internal Med Aco, LLC PastSince Aug 1, 2024 Accepting new patients

Locations

3223 W 63rd St
Chicago, IL 60629
Phone (773) 735-4884

800 Biesterfield Rd
Ste 104
Elk Grove Village, IL 60007
Phone (847) 593-9182

601 W Golf Rd
Ste 105
Mt Prospect, IL 60056
Phone (630) 521-3132

120 Spalding Dr
Ste 410
Naperville, IL 60540
Phone (630) 369-0780

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

855 Madison St
Oak Park, IL 60302
Phone (708) 386-1000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mtanna252212@direct.myadvocateaurora.org
  • Direct secure messaging: mtanna42369@direct.acumenmd.com

Organizations & group practices 11

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 4

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1821096470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W GOLF RD STE 105",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600564276",
            "telephone_number": "847-439-8780",
            "fax_number": "847-439-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNA",
        "first_name": "MANISH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036096147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1616108",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtanna252212@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 W Golf Rd Ste 105",
            "city": "Mount Prospect",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600564276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "601 W Golf Rd Ste 105",
            "city": "Mount Prospect",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600564276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.