Individual provider Active NPI

Andre Thomas Jr., MD

  • Radiation Oncology Physician
  • Chicago, IL
National Provider Identifier
1518603869
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
125.081174 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 834-8288
NPI assigned
May 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Radiation Oncology Physician 2085R0001X 125.081174 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250320002993 IL Order and Referring Only - Radiation OncologyPractitioner - Radiation Oncology 6507246592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.081174ILMDRadiation Oncology Physician

Interoperability endpoints

  • Direct secure messaging: andre.thomas.1@7598.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1518603869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ANDRE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2023-05-11",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "125.081174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.