Active NPI
Thomas L Nelson, R.K.T.
- Kinesiotherapist
- Lake Forest, IL
National Provider Identifier
1043261464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- License
- 1517
- Practice address
- 1044 N Western Ave
Suite C
Lake Forest, IL 60045-1282 - Phone
- (847) 234-0404
- NPI assigned
- May 12, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | 1517 | IL | Primary |
Addresses
Primary practice location
1044 N Western Ave
Suite C
Lake Forest, IL 60045-1282
Mailing address
33278 N Algonquin Dr
Wildwood, IL 60030-1901
Phone (847) 223-4017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1517 | IL | MD | Kinesiotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1043261464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33278 N ALGONQUIN DR",
"city": "WILDWOOD",
"state": "IL",
"postal_code": "600301901",
"telephone_number": "847-223-4017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 N WESTERN AVE",
"address_2": "SUITE C",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600451282",
"telephone_number": "847-234-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "THOMAS",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "R.K.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": "IL",
"license": "1517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.