TATIANA VITALIA BUONICORE (APRN-FPA) – Nurse Practitioner, NPI 1366800906

TATIANA VITALIA BUONICORE (APRN-FPA) is a healthcare provider. based in Burbank, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN-FPA. They hold a License No. 277001003 (IL). The NPI Number for TATIANA VITALIA BUONICORE (APRN-FPA) is 1366800906

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
TATIANA VITALIA BUONICORE (APRN-FPA)
NPI
1366800906
Phone
(708) 424-9200
Address
5635 STATE RD
Enumeration Date
9 February 2016
Last Update Date
24 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7082378918
Graduation Year
2011 (15 years ago)
PAC ID
2062719917
Group Practice PAC ID
4183798127
Professional Enrollment ID
I20160321002373
Address ID
IL604592051BU5635XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for TATIANA VITALIA BUONICORE (APRN-FPA)

  • Stickey Township South Clinic, 5635, State Road, Burbank, Stickney Township, Cook County, Illinois, 60459, United States

    BURBANK, IL 604592051

    Phone: (708) 424-9200

    Type: Mailing

  • Rush Oak Park Hospital, 520, South Maple Avenue, Oak Park, Cook County, Illinois, 60304, United States

    OAK PARK, IL 603041022

    Phone: (708) 785-8100

    Type: Location

  • 5635 STATE RD

    BURBANK, IL 604592051

    Phone: (708) 424-9200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-03-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160321002373INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60459)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183798127View full group profile
NameSpecialtyState
Emergency Medicine, General PracticeIL
Internal MedicineIL
-IL
P O D I A T R YIL

Reviews

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Frequently asked questions

Is TATIANA VITALIA BUONICORE (APRN-FPA) listed with a National Provider Identifier?
Yes — TATIANA VITALIA BUONICORE (APRN-FPA) has NPI 1366800906 on file in the registry.
Active or inactive — what applies to TATIANA VITALIA BUONICORE (APRN-FPA)?
You should see TATIANA VITALIA BUONICORE (APRN-FPA) as active in CMS-hosted NPPES data.
What area of care is associated with TATIANA VITALIA BUONICORE (APRN-FPA)?
TATIANA VITALIA BUONICORE (APRN-FPA)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for TATIANA VITALIA BUONICORE (APRN-FPA)?
Travel planning: use Burbank, Illinois as the reference point for TATIANA VITALIA BUONICORE (APRN-FPA), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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