Active NPI
Thao T Doan, MD
- Allergy & Immunology Physician
- Libertyville, IL
National Provider Identifier
1649749813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 036.079568
- Practice address
- 523 Sandy LN
Libertyville, IL 60048-3553 - Phone
- (847) 816-7245
- NPI assigned
- Nov 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 036.079568 | IL | Primary |
Addresses
Primary practice location
523 Sandy LN
Libertyville, IL 60048-3553
Mailing address
523 Sandy LN
Libertyville, IL 60048-3553
Phone (847) 816-7245
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.079568 | IL | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542412800000",
"number": "1649749813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 SANDY LN",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483553",
"telephone_number": "847-816-7245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 SANDY LN",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483553",
"telephone_number": "847-816-7245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOAN",
"first_name": "THAO",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-17",
"last_updated": "2018-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "IL",
"license": "036.079568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.