Individual provider Active NPI

Alfred John Tedeschi, MA, ATC, PES

  • Other Specialist/Technologist
  • Deerfield, IL
National Provider Identifier
1366418980
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Practice address
550 Lake Cook Rd
Deerfield, IL 60015-4921
Phone
(847) 444-8728
Fax
(847) 444-8998
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X IL Primary

Addresses

Primary practice location

550 Lake Cook Rd
Deerfield, IL 60015-4921

Mailing address

550 Lake Cook Rd
Deerfield, IL 60015-4921
Phone (847) 444-8728

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
096-001404ILMDOther Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366418980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154921",
            "telephone_number": "847-444-8728",
            "fax_number": "847-444-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154921",
            "telephone_number": "847-444-8728",
            "fax_number": "847-444-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCHI",
        "first_name": "ALFRED",
        "middle_name": "JOHN",
        "credential": "MA, ATC, PES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.