| NPI | 1073163838 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2019-09-13 |
| Last Updated | 2025-01-13 |
| Mailing Address | Po Box 268 Freeport, IL 61032-0268 United States 📍 View Map |
| Primary Practice Address | 1010 Fairway Dr Freeport, IL 61032-6600 United States Phone: (815) 599-6000 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 363LF0000X – Nurse Practitioner, Family | IL | 209019884 |
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About NPI 1073163838
Tamisha Bonvillain FNP-BC is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1073163838. The primary specialty listed is Nurse Practitioner, Family. The provider is located in Freeport, IL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2019-09-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073163838?
NPI 1073163838 belongs to Tamisha Bonvillain FNP-BC, a Nurse Practitioner, Family in Freeport, IL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073163838 active?
The current status of NPI 1073163838 in the NPPES registry is Active. The record was last updated on 2025-01-13.
What specialty is NPI 1073163838?
NPI 1073163838 is classified under the taxonomy Nurse Practitioner, Family. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073163838?
You can verify NPI 1073163838 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073163838?
The primary practice address on file for NPI 1073163838 is 1010 Fairway Dr, Freeport, IL 61032-6600. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073163838 issued?
NPI 1073163838 was first issued (enumerated) on 2019-09-13. The NPPES record was last updated on 2025-01-13.
Practice Location Map
Tamisha Bonvillain is located at 1010 Fairway Dr, Freeport, IL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Tamisha Bonvillain. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1073163838. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Nurse Practitioner, Family | 209019884 | IL |