Healthcare Provider Details

I. General information

NPI: 1922689553
Provider Name (Legal Business Name): CLAIRE LUCIENNE TANAGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA CLAIRE LUCINNE PALMARINI

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N ELM ST
GREENSBORO NC
27401-1004
US

IV. Provider business mailing address

150 HARVESTER DR STE 300
BURR RIDGE IL
60527-5965
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.171710
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2025-02388
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: