Individual provider Active NPI

Thomas Edmund Malone, M.AC., PH.D., L.AC.

  • Acupuncturist
  • Evanston, IL
National Provider Identifier
1053754085
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198001036 Issued in IL
Practice address
500 Davis St
Suite 815
Evanston, IL 60201-4668
Phone
(773) 680-0081
NPI assigned
Apr 9, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198001036 IL Primary

Addresses

Primary practice location

500 Davis St
Suite 815
Evanston, IL 60201-4668

Mailing address

2448 W Estes Ave
Unit 2
Chicago, IL 60645-3311
Phone (773) 680-0081

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
198001036ILMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1053754085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 W ESTES AVE",
            "address_2": "UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453311",
            "telephone_number": "773-680-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DAVIS ST",
            "address_2": "SUITE 815",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014668",
            "telephone_number": "773-680-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "THOMAS",
        "middle_name": "EDMUND",
        "name_prefix": "Dr.",
        "credential": "M.AC., PH.D., L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198001036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.