Individual provider Active NPI

Taryrsha Davis, APN

  • Nurse Practitioner
  • Hazel Crest, IL
National Provider Identifier
1821552761
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.018789 Issued in IL
Practice address
17504 E Carriageway Dr
Hazel Crest, IL 60429-2087
Phone
(312) 636-3722
Fax
(773) 299-9299
NPI assigned
Jan 24, 2019
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.023614 IL
Nurse Practitioner 363L00000X 209.018789 IL Primary

Addresses

Primary practice location

17504 E Carriageway Dr
Hazel Crest, IL 60429-2087

Mailing address

17504 E Carriageway Dr
Hazel Crest, IL 60429-2087
Phone (312) 636-3722

Other names 1

  • Ms. Taryrsha Davis Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190228002263 IL Practitioner - Nurse Practitioner 7911246368 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Immediate Home Care Providers P CGroup PAC ID 2062934490, 4 clinicians
Immediate Home Care Physicians IncGroup PAC ID 2567521594, 2 clinicians
Midwest Wound Care IncorporatedGroup PAC ID 3173052719, 2 clinicians
Healing Hands Physicians IncGroup PAC ID 8921284027, 4 clinicians
Chicagoland Infectious Disease PCGroup PAC ID 5193948362, 38 clinicians
At Your Door Physician CareGroup PAC ID 3678963279, 2 clinicians

Practice addresses (Care Compare)

10714 S Roberts Rd
Palos Hills, IL 60465-2314
Phone (708) 631-1326

1190 Lily Cache LN
Apt 103
Bolingbrook, IL 60490-3284
Phone (630) 755-1695

1305 Remington Rd
Suite M
Schaumburg, IL 60173-4820
Phone (224) 938-9264

17901 Governors Hwy
Suite 206
Homewood, IL 60430-1146
Phone (708) 880-0559

343 N Wood Dale Rd
Suite 102
Wood Dale, IL 60191-1565
Phone (773) 299-9299

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.018789ILMDNurse Practitioner
209.023614ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Social Services of Illinois Nurse Practitioner CurrentSince Apr 17, 2019 Accepting new patients
Immediate Home Care Providers P C CurrentSince Mar 1, 2025 Accepting new patients
New Southtown Medical Group S C CurrentSince Sep 15, 2020 Accepting new patients
Immediate Home Care Physicians, Inc CurrentSince Jan 6, 2025 Accepting new patients
Lutheran Social Services of Illinois Nurse Practitioner CurrentSince Apr 17, 2019 Accepting new patients
Vpa PC Current Accepting new patients
Healing Hands Physicians, Inc. CurrentSince May 1, 2023 Accepting new patients
Practitioner2Youllc Current Accepting new patients
At Your Door Transportation LLC CurrentSince Apr 24, 2022 Accepting new patients
Midwest Wound Care Incorporated CurrentSince Jan 1, 2025 Accepting new patients
Vpa PC CurrentSince Feb 7, 2019 Accepting new patients
Unity Hospice of Chicagoland LLC CurrentSince Feb 1, 2022 Accepting new patients
Vpa PC CurrentSince Feb 7, 2019 Accepting new patients
B&a Health Provider LLC CurrentSince May 1, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Dec 7, 2019 Accepting new patients
Chicagoland Infectious Disease PC CurrentSince Mar 3, 2025 Accepting new patients

Locations

4840 W Byron St
Chicago, IL 60641
Phone (773) 282-7800

5215 N California Ave
Ste F101
Chicago, IL 60625
Phone (773) 561-5809

600 W Cermak Rd
Ste 3D
Chicago, IL 60616
Phone (312) 427-6000

8205 Cass Ave
Ste 110B
Darien, IL 60561
Phone (773) 840-4747

1001 E Touhy Ave
Ste 170
Des Plaines, IL 60018
Phone (847) 390-1422

17901 Governors Hwy
Ste 206
Homewood, IL 60430
Phone (708) 957-9100

10714 S Roberts Rd
Palos Hills, IL 60465
Phone (708) 631-1326

1305 Remington Rd
Ste M
Schaumburg, IL 60173
Phone (224) 938-9264

4101 Main St
Skokie, IL 60076
Phone (312) 847-2458

430 E 162nd St
South Holland, IL 60473
Phone (312) 504-5757

343 N Wood Dale Rd
Wood Dale, IL 60191
Phone (773) 299-9299

343 N Wood Dale Rd
Ste 102
Wood Dale, IL 60191
Phone (773) 299-9299

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Interoperability endpoints

  • Direct secure messaging: taryrsha.davis.1@33292.direct.athenahealth.com
  • Direct secure messaging: taryrsha.davis.p1@direct.thmg.nextgenshare.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 8

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1821552761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17504 E CARRIAGEWAY DR",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292087",
            "telephone_number": "312-636-3722",
            "fax_number": "773-299-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17504 E CARRIAGEWAY DR",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292087",
            "telephone_number": "312-636-3722",
            "fax_number": "773-299-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TARYRSHA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.023614",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.018789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARYRSHA",
            "last_name": "DAVIS",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hazel Crest, IL

Sources for this page

Verify at the official NPI Registry.