TDK Family Medical Centers LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TDK FAMILY MEDICAL CENTERS LLC

Doing business as

Prairie Medical Group

Practice address

2434 Wolf Rd
Westchester, IL 60154-5634

Phone

(708) 562-5430

Fax

(708) 562-8330

NPI assigned

Mar 5, 2007

Last updated

May 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas M Nelson, D.O.NPI 1770535973

Title

Managing Partner

Phone

(708) 562-5430

Specialties & licenses 2

Addresses

Other names 1

• PRAIRIE MEDICAL GROUP Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Nelson, DO

  • Family Medicine Physician
  • Westchester, IL
  • NPI 1770535973
  Authorized official Same address or phone

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1508995762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 WOLF RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545634",
            "telephone_number": "708-562-5430",
            "fax_number": "708-562-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 WOLF RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545634",
            "telephone_number": "708-562-5430",
            "fax_number": "708-562-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDK FAMILY MEDICAL CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "708-562-5430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRAIRIE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Westchester, IL
• Providers in Westchester, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.