Theodore Scott Landers, O.T.C.

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Practice address

901 Biesterfield Rd
Suite 300
Elk Grove Village, IL 60007-3392

Phone

(847) 437-9889

Fax

(847) 301-2829

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346450129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 SANTA FE LN",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801624",
            "telephone_number": "708-467-0467",
            "fax_number": "815-327-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BIESTERFIELD RD",
            "address_2": "SUITE 300",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073392",
            "telephone_number": "847-437-9889",
            "fax_number": "847-301-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERS",
        "first_name": "THEODORE",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "O.T.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Specialist/Technologist in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Other Specialist/Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.