Tisha Joerla Mirasol Tan, MD in Crystal Lake, IL

Tisha Joerla Mirasol Tan, MD is a medicare enrolled "Internal Medicine - Nephrology" physician in Crystal Lake, Illinois. She graduated from medical school in 2008 and has 16 years of diverse experience with area of expertise as Nephrology. She is a member of the group practice Kidney Care Center Elgin Llc and her current practice location is 442 N Il Route 31, Crystal Lake, Illinois. You can reach out to her office (for appointments etc.) via phone at (224) 238-3211.

Tisha Joerla Mirasol Tan is licensed to practice in Illinois (license number 036137011) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1881959872.

Contact Information

	Tisha Joerla Mirasol Tan, MD
	442 N Il Route 31, Crystal Lake, IL 60012-3709
	(224) 238-3211
	(224) 535-8215

Map and Direction

Physician's Profile

Full Name	Tisha Joerla Mirasol Tan
Gender	Female
Speciality	Nephrology
Experience	16 Years
Location	442 N Il Route 31, Crystal Lake, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Tisha Joerla Mirasol Tan graduated from medical school in 2008

NPI Data:

NPI Number: 1881959872
Provider Enumeration Date: 07/06/2012
Last Update Date: 09/15/2022

Medicare PECOS Information:

PECOS PAC ID: 5294037958
Enrollment ID: I20170322000482

Medical Identifiers

Medical identifiers for Tisha Joerla Mirasol Tan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1881959872	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RN0300X	Internal Medicine - Nephrology	036137011 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Home Dialysis Services Elgin Llc	Crystal lake, IL	Dialysis facility
Concerto Dialysis	Crestwood, IL	Dialysis facility
Northwestern Medicine Mchenry Hospital	Mchenry, IL	Hospital
Central Dupage Hospital	Winfield, IL	Hospital
Advocate Good Shepherd Hospital	Barrington, IL	Hospital
Advocate Sherman Hospital	Elgin, IL	Hospital
Northwest Community Hospital 1	Arlington heights, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Kidney Care Center Elgin Llc	2769634252	5

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tisha Joerla Mirasol Tan allows following entities to bill medicare on her behalf.

Entity Name	Kidney Care Center Elgin Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508126764 PECOS PAC ID: 2769634252 Enrollment ID: O20121207000412

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tisha Joerla Mirasol Tan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Tisha Joerla Mirasol Tan, MD Po Box 3877, Joliet, IL 60434-3877 Ph: (815) 741-6830	Tisha Joerla Mirasol Tan, MD 442 N Il Route 31, Crystal Lake, IL 60012-3709 Ph: (224) 238-3211

Reviews and Comments

Internal Medicine Doctors in Crystal Lake, IL

Dr. Raman I Popli, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 145 S Virginia St Ste C, Crystal Lake, IL 60014 Phone: 815-363-6055 Fax: 815-363-6150
Dr. Irfan K Moinuddin, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 442 N Il Route 31, Crystal Lake, IL 60012 Phone: 224-238-3211
Dr. Veera A Rao, MD Nephrology Medicare: Medicare Enrolled Practice Location: 690 E Terra Cotta Ave Ste A, Crystal Lake, IL 60014 Phone: 815-455-2452 Fax: 815-455-2789
Nitin Kher, Nephrology Medicare: Accepting Medicare Assignments Practice Location: 690 E Terra Cotta Ave Ste A, Crystal Lake, IL 60014 Phone: 815-307-8075 Fax: 815-344-4302
Dr. Sandeep Chunduri, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 525 E Congress Pkwy, Suite 300, Crystal Lake, IL 60014 Phone: 815-759-9260 Fax: 815-459-7460
Mr. Mohit Arora, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 690 E Terra Cotta Ave, Suite D, Crystal Lake, IL 60014 Phone: 815-455-8600 Fax: 815-455-8601
Mr. Brian M-y Wu, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 6317 Nw Hwy, Crystal Lake, IL 60014 Phone: 815-459-4333 Fax: 815-477-7279

Tisha Joerla Mirasol Tan, MD - Medicare Nephrology in Crystal Lake, IL