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DR. JONATHAN BAUTISTA TANAWAN MD
NPI 1609443571
Family Medicine - Addiction Medicine in Chicago, IL

Active since June 08, 2021PECOS EnrolledAccepts Medicare Assignment
1969 W OGDEN AVE, CHICAGO, IL 60612(312) 864-0516(312) 491-5020 Get Directions Write a Review

NPPES record last updated: August 26, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2024, Jun 8, 2021 (2 updates tracked since 2021).

About Dr. Jonathan Bautista Tanawan Md NPPES

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

DR. JONATHAN BAUTISTA TANAWAN MD (NPI 1609443571) is an individual addiction medicine provider in Chicago, Illinois, licensed in Illinois (036.170234) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1609443571
Entity TypeIndividualMale
Primary Taxonomy207QA0401X
Provider Legal NameDR. JONATHAN BAUTISTA TANAWANCredential: MD
Location Address1969 W OGDEN AVEChicago, IL 60612-3765
Mailing Address1431 N Western Ave Ste 406Chicago, IL 60622-1774 · (312) 633-5841 · Fax (312) 491-5020
Phone(312) 864-0516
Fax(312) 491-5020
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJune 8, 2021
Last NPPES UpdateAugust 26, 20252 updates tracked since enumeration
NPPES CertifiedAugust 26, 2025
✔ NPI 1609443571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in IL · 036.170234
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 036.170234 (IL)
1969 W OGDEN AVE, Chicago, IL 60612
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jonathan Bautista Tanawan Md 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 ID941602619
PECOS Enrollment IDI20240729001651
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
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.

DR. VIGNESH CHIDAMBARAM MD, MPH
Internal Medicine (Cardiovascular Disease)
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-6000
LUCAS KUZMANIC DO
Internal Medicine
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-6000
KEERTHIKA VIJAYAKUMAR MBBS
Internal Medicine
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-6000
DR. KEVIN BOUBOULEIX
Emergency Medicine
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-6000
NABEEL ZIA AHMED
Internal Medicine
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-6000
DR. VAMSI KRISHNA KAZA M.D., MBBS
Internal Medicine
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-6000
CHRISTINE MARIA WHIPPLE LCSW
Social Worker (Clinical)
1969 W OGDEN AVE, ROOM 1698
CHICAGO, IL 60612
Cook County (312) 864-1466
LESLIE FENIO PA-C
Physician Assistant
1969 W OGDEN AVE
CHICAGO, IL 60612
Cook County (312) 864-7761

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 Jonathan Tanawan's NPI number?

The NPI number for Jonathan Tanawan is 1609443571. It was assigned to this individual provider in the NPPES registry on June 8, 2021.

Where is Jonathan Tanawan located?

Jonathan Tanawan practices at 1969 W Ogden Ave, Chicago, IL 60612. The listed phone number is (312) 864-0516.

What is Jonathan Tanawan's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Is Jonathan Tanawan enrolled in Medicare?

Yes. Jonathan Tanawan 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.

When was this NPI record last updated?

The NPPES record for Jonathan Tanawan was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.