Thomas N Porter MD SC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

THOMAS N PORTER MD SC

Practice address

755 S Milwaukee Ave
Ste 263
Libertyville, IL 60048-3266

Phone

(847) 367-1151

Fax

(847) 367-8729

NPI assigned

Oct 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thomas N Porter, MD

Title

Physician, President

Phone

(847) 367-1151

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1053500801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "STE 263",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483266",
            "telephone_number": "847-367-1151",
            "fax_number": "847-367-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "STE 263",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483266",
            "telephone_number": "847-367-1151",
            "fax_number": "847-367-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS N PORTER MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICIAN, PRESIDENT",
        "authorized_official_telephone_number": "847-367-1151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04915342",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.