Individual provider Active NPI

Thomas Richard Hurley, M.D.

  • Neurological Surgery Physician
  • New Lenox, IL
National Provider Identifier
1558418103
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036-080115 Issued in IL
Practice address
1890 Silver Cross Blvd
New Lenox, IL 60451
Phone
(815) 723-4387
Fax
(815) 723-4634
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036-080115 IL Primary

Addresses

Primary practice location

1890 Silver Cross Blvd
New Lenox, IL 60451

Mailing address

1890 Silver Cross Blvd
New Lenox, IL 60451-9518
Phone (815) 723-4387

Other identifiers 4

IdentifierTypeStateIssuer
206147OtherILMEDICARE (GROUP)
036080115MedicaidIL
CA4748OtherILRAILROAD MEDICARE (INDIVIDUAL)
206147202OtherILMEDICARE (INDIVIDUAL)

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-080115ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Institute of Neurosurgery & Neuroresearch Neurological Surgery Past Accepting new patients

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1558418103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519518",
            "telephone_number": "815-723-4387",
            "fax_number": "815-723-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-723-4387",
            "fax_number": "815-723-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036-080115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (GROUP)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080115",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE (INDIVIDUAL)",
            "identifier": "CA4748",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (INDIVIDUAL)",
            "identifier": "206147202",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.