Individual provider Active NPI

John Joseph Taglia, MD

  • Psychiatry Physician
  • Palos Heights, IL
National Provider Identifier
1841221173
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036161593 Issued in IL
Practice address
7808 W College Dr Ste 2W
Palos Heights, IL 60463-1098
Phone
(708) 631-5110
NPI assigned
Jul 5, 2006
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036161593 IL Primary

Addresses

Primary practice location

7808 W College Dr Ste 2W
Palos Heights, IL 60463-1098

Mailing address

1401 Niles Ave
Saint Joseph, MI 49085-1584
Phone (773) 531-1747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170421000284 IN Practitioner - Psychiatry 4789687658 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036161593ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Indiana, Auditor of State CurrentSince Apr 3, 2017 Accepting new patients
State of Indiana, Auditor of State Current Accepting new patients
State of Indiana, Auditor of State CurrentSince Apr 3, 2017 Accepting new patients
State of Michigan Office of Financial Management PastSince Sep 24, 2023 Accepting new patients

Locations

1098 S State Road 25
Logansport, IN 46947
Phone (574) 722-4141

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1841221173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 NILES AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851584",
            "telephone_number": "773-531-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 W COLLEGE DR STE 2W",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631098",
            "telephone_number": "708-631-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGLIA",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036161593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.