1. Home
  2. Directory
  3. Illinois
  4. Evergreen Park
  5. Nurse Practitioner
  6. NPI Profile

TIFFANY CLAIRE WAKIM GHANTOUS MSN, APRN, FNP-C
NPI 1396517496
Nurse Practitioner - Family in Evergreen Park, IL

Active since October 23, 2023PECOS EnrolledAccepts Medicare Assignment
2955 W 95TH ST, EVERGREEN PARK, IL 60805(708) 422-0022 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 23, 2026, Oct 30, 2023, Oct 23, 2023 (3 updates tracked since 2023).

About Tiffany Claire Wakim Ghantous Msn, Aprn, Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY CLAIRE WAKIM GHANTOUS MSN, APRN, FNP-C (NPI 1396517496) is an individual family provider in Evergreen Park, Illinois, licensed in Illinois (209.028519) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1396517496
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTIFFANY CLAIRE WAKIM GHANTOUSCredential: MSN, APRN, FNP-C
Location Address2955 W 95TH STEvergreen Park, IL 60805-2409
Mailing Address445 E Illinois St Unit 5509Chicago, IL 60611-0820 · (630) 408-3563
Phone(708) 422-0022
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 23, 2023
Last NPPES UpdateMarch 23, 20263 updates tracked since enumeration
NPPES CertifiedMarch 23, 2026
✔ NPI 1396517496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.028519
2955 W 95TH ST, Evergreen Park, IL 60805
Open in Google Maps ↗

Other Names 1

Former Name (1)Tiffany Wakim

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tiffany Claire Wakim Ghantous Msn, Aprn, Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204286768
PECOS Enrollment IDI20231223000106
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Tiffany Wakim Ghantous reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Diabetes & Endocrine Care Ltd
Same address
Endocrinology, Diabetes & Metabolism
2955 W 95TH ST
Evergreen Park, IL 60805
  • Reassigned Medicare billing, Illinois enrollment
  • 6 clinicians in this Medicare group
NPI 1689627168 (708) 422-0022
Great Lakes Emergency Physicians Medical Group Sc
6.3 mi
Emergency Medicine
7531 S STONY ISLAND AVE
Chicago, IL 60649
  • Reassigned Medicare billing, Illinois enrollment
  • 25 clinicians in this Medicare group
NPI 1689212581 (773) 947-7500
Rush University Medical Center
11 mi
Internal Medicine
1411 S MICHIGAN AVE
Chicago, IL 60605
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Rush University Medical Group
  • 2,169 clinicians in this Medicare group
NPI 1689165540 (312) 563-0654

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KYTORI TOLBERT MSN, APRN, FNP
Nurse Practitioner (Family)
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 423-2880
JENNIFER COURTS APN
Nurse Practitioner (Family)
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 425-9399
ANGELIKA FIEDOROWICZ APRN
Nurse Practitioner (Family)
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (331) 204-5896
DR. ABDALLAH ALTARSHAN MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 422-0022
MATTHEW DAVID RATHBUN NP
Nurse Practitioner (Primary Care)
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (331) 814-2186
SOUTHWEST PHYSICIANS ASSOCIATES, S. C.
Family Medicine
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 200-6615
NUSAIBAH MOHSIN
Physician Assistant
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 425-9399
PRIME PLUS PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
2955 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 741-7501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Wakim Ghantous's NPI number?

The NPI number for Tiffany Wakim Ghantous is 1396517496. It was assigned to this individual provider in the NPPES registry on October 23, 2023. The provider is also known as Tiffany Wakim.

Where is Tiffany Wakim Ghantous located?

Tiffany Wakim Ghantous practices at 2955 W 95th St, Evergreen Park, IL 60805. The listed phone number is (708) 422-0022.

What is Tiffany Wakim Ghantous's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tiffany Wakim Ghantous enrolled in Medicare?

Yes. Tiffany Wakim Ghantous is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Tiffany Wakim Ghantous's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Wakim Ghantous reassigns Medicare benefits to 3 organizations: Diabetes & Endocrine Care Ltd (Evergreen Park, IL), Great Lakes Emergency Physicians Medical Group Sc (Chicago, IL) and Rush University Medical Center (Chicago, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tiffany Wakim Ghantous's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tiffany Wakim Ghantous was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.