Individual provider Active NPI

Nancy A Tucker, M.D.

  • Ophthalmology Physician
  • Tinley Park, IL
National Provider Identifier
1295734416
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Practice address
16650 Harlem Ave
Tinley Park, IL 60477-1847
Phone
(708) 444-7200
Fax
(708) 444-7233
NPI assigned
Jul 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X IL Primary

Addresses

Primary practice location

16650 Harlem Ave
Tinley Park, IL 60477-1847

Mailing address

PO Box 459
Matteson, IL 60443-0459
Phone (708) 747-5850

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

State licenses

LicenseStateTypeSpecialty
036104812ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas J Conti MD Dba Illinois Oculoplastic Associates SC Ophthalmology Past Accepting new patients
Illinois Oculoplastic Associates SC Ophthalmology PastSince Oct 1, 2006 Accepting new patients
Illinois Glaucoma Center, LTD Ophthalmology Past Accepting new patients
Illinois Retina Associates PLLC Ophthalmology PastSince Feb 6, 2022 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1295734416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430459",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16650 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771847",
            "telephone_number": "708-444-7200",
            "fax_number": "708-444-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "NANCY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.