Provider Demographics
NPI:1124443031
Name:CHIRAYIL, TANYA TREASA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:TREASA
Last Name:CHIRAYIL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:TREASA
Other - Last Name:UTHUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:847-982-6715
Mailing Address - Fax:
Practice Address - Street 1:9650 GROSS POINT RD STE 3900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5085
Practice Address - Country:US
Practice Address - Phone:847-570-2570
Practice Address - Fax:847-933-3520
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011189363L00000X
IL209011189041355741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily