Thomas H Burnstine, M.D.,S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036079533 Issued in IL

Legal business name

THOMAS H BURNSTINE, M.D.,S.C.

Practice address

755 S Milwaukee Ave
Suite 220
Libertyville, IL 60048-3253

Phone

(847) 816-0500

Fax

(847) 816-3212

NPI assigned

Aug 27, 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 H Burnstine, M.D.

Title

Sole Proprietor

Phone

(224) 628-1256

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1073706685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650187",
            "telephone_number": "224-628-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "SUITE 220",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483253",
            "telephone_number": "847-816-0500",
            "fax_number": "847-816-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS H BURNSTINE, M.D.,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "BURNSTINE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "224-628-1256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036079533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.