Provider Demographics
NPI:1356985279
Name:MARKOV, TANYA (APRN)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:MARKOV
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 MCHENRY RD STE 215
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1371
Mailing Address - Country:US
Mailing Address - Phone:224-659-2785
Mailing Address - Fax:
Practice Address - Street 1:1207 MCHENRY RD STE 215
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1371
Practice Address - Country:US
Practice Address - Phone:847-943-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020247363LF0000X
IL277002180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily