Thomas G Godbout III, D.C., CCSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

038010264 Issued in IL

Practice address

1352 Patriot Blvd
Glenview, IL 60026-7777

Phone

(847) 657-0400

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Back to Life Chiropractic, SC

  • Sports Physician Chiropractor
  • Glenview, IL
  • NPI 1194983650
  Medicare reassignment NPD Authorized official
• Sommo LLC

  dba ProFormance Therapy

  • Physical Therapy Clinic/Center
  • Glenview, IL
  • NPI 1639530371
  NPD
• Whitney Chiropractic LLC

  • Sports Physician Chiropractor
  • Naperville, IL
  • NPI 1639732357
  NPD (past)
• Whitney Chiropractic S.C.

  • Sports Physician Chiropractor
  • Lisle, IL
  • NPI 1811027873
  NPD (past)
• State Street Chiropractic, Inc

  • Chiropractor
  • Boston, MA
  • NPI 1326191941
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1669500104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600267777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600267777",
            "telephone_number": "847-657-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBOUT",
        "first_name": "THOMAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C., CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010264",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038010264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K51546",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• GN Hearing Care Corp (Beltone)
• GN Hearing Care Corp (Beltone Electronics)
• Daniel C. Go, MD
• Grace Go
• Ronald Go
• Priya P. Goel
• Trupti Binal Gokani, MD
• Annie Goldberg
• Sarah Danielle Goldberg, PSY.D.
• Keri Golding, LCSW

• Sports Physician Chiropractor in Glenview, IL
• Providers in Glenview, IL by specialty
• Sports Physician Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.