Active NPI
Dr Nicholas M Tabor III DPM
- Podiatrist
- Ottawa, IL
National Provider Identifier
1619146016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- DR NICHOLAS M TABOR III DPM
- Practice address
- 1703 Polaris Cir
Ottawa, IL 61350-1683 - Phone
- (815) 433-5600
- Fax
- (815) 434-0933
- NPI assigned
- Feb 29, 2008
- Last updated
- Mar 4, 2008
- Organization subpart
- Yes
- Parent organization
- DR NICHOLAS M TABOR III DPM
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nicholas M Tabor III, DPM
- Title
- Owner
- Phone
- (815) 224-3535
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | NU | Primary |
Addresses
Primary practice location
1703 Polaris Cir
Ottawa, IL 61350-1683
Mailing address
1703 Polaris Cir
Ottawa, IL 61350-1683
Phone (815) 433-5600
National Provider Directory
National Provider Directory- Part of
- Dr Nicholas M Tabor III DPM
Practitioners & affiliated clinicians
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.
-
- Podiatrist
- La Salle, IL
- NPI 1255327441
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204243200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204588800000",
"number": "1619146016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 POLARIS CIR",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613501683",
"telephone_number": "815-433-5600",
"fax_number": "815-434-0933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 POLARIS CIR",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613501683",
"telephone_number": "815-433-5600",
"fax_number": "815-434-0933"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR NICHOLAS M TABOR III DPM",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DR NICHOLAS M TABOR III DPM",
"enumeration_date": "2008-02-29",
"last_updated": "2008-03-04",
"status": "A",
"authorized_official_last_name": "TABOR",
"authorized_official_first_name": "NICHOLAS",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "815-224-3535",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.