Individual provider Active NPI

Tiffany Amber Deriggi, MSN

  • Neonatal Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1982975694
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
209.009292 Issued in IL
Practice address
3831 N Sacramento Ave
Apt 1
Chicago, IL 60618-3530
Phone
(708) 574-0169
NPI assigned
Jan 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 209.009292 IL Primary

Addresses

Primary practice location

3831 N Sacramento Ave
Apt 1
Chicago, IL 60618-3530

Mailing address

3831 N Sacramento Ave
Apt 1
Chicago, IL 60618-3530
Phone (708) 574-0169

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
I20121103000076 IL Practitioner - Nurse Practitioner 9335390160 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.009292ILMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Group CurrentSince Oct 1, 2020 Accepting new patients
Bonaventure Medical Foundation, LLC CurrentSince Oct 2, 2018 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
#622
Chicago, IL 60612
Phone (312) 942-5068

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412

Interoperability endpoints

  • Direct secure messaging: tderiggi50868@direct.rush.rush-health.com

Organizations & group practices 3

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": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1982975694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 N SACRAMENTO AVE",
            "address_2": "APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183530",
            "telephone_number": "708-574-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 N SACRAMENTO AVE",
            "address_2": "APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183530",
            "telephone_number": "708-574-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIGGI",
        "first_name": "TIFFANY",
        "middle_name": "AMBER",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IL",
            "license": "209.009292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.