Individual provider Active NPI

Tiffany HN Tang, OD

  • Optometrist
  • Chicago Heights, IL
National Provider Identifier
1902335391
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011093 Issued in IL
Practice address
366 Dixie Hwy
Chicago Heights, IL 60411-1758
Phone
(708) 754-0080
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011093 IL Primary

Addresses

Primary practice location

366 Dixie Hwy
Chicago Heights, IL 60411-1758

Mailing address

701 Midwest Club Pkwy
Oak Brook, IL 60523-2531
Phone (630) 427-5579

Other practice location 1

701 Midwest Club
Oak Brook, IL 60523
Phone (630) 427-5579

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170811002906 IL Practitioner - Optometry 7214208057 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011093ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Holmberg Optometric LTD Optometrist CurrentSince Feb 1, 2018 Accepting new patients
R a Vision Corporation Optometrist CurrentSince Jun 9, 2024 Accepting new patients

Locations

366 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 754-0080

118 Main St
Park Ridge, IL 60068
Phone (847) 696-6444

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902335391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MIDWEST CLUB PKWY",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232531",
            "telephone_number": "630-427-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111758",
            "telephone_number": "708-754-0080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Midwest Club",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "60523",
            "country_code": "US",
            "telephone_number": "630-427-5579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANG",
        "first_name": "TIFFANY",
        "middle_name": "HN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

Verify at the official NPI Registry.