Individual provider Active NPI

Thomas Kiely, D.P.M.

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1477552677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003749 Issued in IL
Practice address
3000 N Halsted St
Suite 301
Chicago, IL 60657-5188
Phone
(773) 296-7160
Fax
(773) 296-3440
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003749 IL Primary

Addresses

Primary practice location

3000 N Halsted St
Suite 301
Chicago, IL 60657-5188

Mailing address

3000 N Halsted St
Suite 301
Chicago, IL 60657-5188
Phone (773) 296-7160

Other identifiers 1

IdentifierTypeStateIssuer
016003749MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914000577 IL Order and Referring Only - PodiatryPractitioner - Podiatry 2365346533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016003749ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Foot Health Centers, LLC Podiatrist PastSince Sep 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tkiely279359@direct.myadvocateaurora.org

Organizations & group practices 1

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": "1183852800000",
    "number": "1477552677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-296-7160",
            "fax_number": "773-296-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-296-7160",
            "fax_number": "773-296-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELY",
        "first_name": "THOMAS",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003749",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.