Thomas E Vandyke, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085000752 Issued in IL

Practice address

6614 S Halsted St
Chicago, IL 60621-1812

Phone

(773) 651-1224

NPI assigned

May 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Asj MD SC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1740776350
  Medicare reassignment
• Willowbrook Clinics and Medical Center S.C.

  • Family Medicine Physician
  • Willowbrook, IL
  • NPI 1952187072
  NPD (past)

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1083871115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211812",
            "telephone_number": "773-651-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211812",
            "telephone_number": "773-651-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085000752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany R Vandivier
• Renee Vandoren, LCSW
• Jerry Vandoros, D.D.S.
• Jenna Nadine Vanduyne, CCC-SLP
• Caleb Benjamin Vandyke, MD
• Mary C Vanecko, APN, CNM
• Vanessa Bradden, LMFT, P.C.
• Vanessa E Ford, LCSW, P.C.
• Hannah Vanevery
• Amy Marie Vanfossen, DDS

• Medical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.