Active NPI
Billy Tatum
- Rehabilitation Practitioner
- Chicago, IL
National Provider Identifier
1417350414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1436 W. Randolph
5TH Floor
Chicago, IL 60607 - Phone
- (312) 226-8720
- Fax
- (312) 226-8722
- NPI assigned
- Oct 3, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1436 W. Randolph
5TH Floor
Chicago, IL 60607
Mailing address
1436 W Randolph St
5TH Floor
Chicago, IL 60607-1405
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1417350414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1436 W RANDOLPH ST",
"address_2": "5TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606071405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1436 W. RANDOLPH",
"address_2": "5TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60607",
"telephone_number": "312-226-8720",
"fax_number": "312-226-8722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "BILLY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-03",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"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 Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.