Active NPI
Trevor Thomas Nicholson, M.D.
- Pulmonary Disease Physician
- Chicago, IL
National Provider Identifier
1265789770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 036138195
- Practice address
- 675 N Saint Clair St
18-250
Chicago, IL 60611-5975 - Phone
- (312) 695-1800
- NPI assigned
- Aug 14, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036138195 | IL | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 036138195 | IL | |
| Pulmonary Disease Physician | 207RP1001X | 036138195 | IL | Primary |
Addresses
Primary practice location
675 N Saint Clair St
18-250
Chicago, IL 60611-5975
Mailing address
240 E Huron
Pulmonary and Critical Care
Chicago, IL 60611
Phone (312) 695-1800
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1265789770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 E HURON",
"address_2": "PULMONARY AND CRITICAL CARE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-695-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 N SAINT CLAIR ST",
"address_2": "18-250",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115975",
"telephone_number": "312-695-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "TREVOR",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-14",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036138195",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IL",
"license": "036138195",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IL",
"license": "036138195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.