Provider Demographics
NPI:1043677529
Name:CHAVARRIA, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:CHAVARRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TRANSAM PLAZA DR STE 400
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4808
Mailing Address - Country:US
Mailing Address - Phone:630-545-3766
Mailing Address - Fax:630-933-7392
Practice Address - Street 1:2 TRANSAM PLAZA DR STE 400
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4808
Practice Address - Country:US
Practice Address - Phone:630-545-3766
Practice Address - Fax:630-933-7392
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041303804163WW0101X
IN28172884A163WW0101X
IN71002390A363LW0102X
IL209005920363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health