Active NPI
James Tan
- Physical Therapist
- Burr Ridge, IL
National Provider Identifier
1669952560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.023830
- Practice address
- 7055 High Grove Blvd
Burr Ridge, IL 60527-7628 - Phone
- (630) 371-1623
- NPI assigned
- Aug 20, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.023830 | IL | Primary |
Addresses
Primary practice location
7055 High Grove Blvd
Burr Ridge, IL 60527-7628
Mailing address
1027 Bothwell CT
Bolingbrook, IL 60440-1626
Phone (630) 803-7660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070.023830 | Other | IL | DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION ILLINOIS PHYSICAL THERAPIST |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.023830 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1669952560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1027 BOTHWELL CT",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604401626",
"telephone_number": "630-803-7660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7055 HIGH GROVE BLVD",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605277628",
"telephone_number": "630-371-1623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.023830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION ILLINOIS PHYSICAL THERAPIST",
"identifier": "070.023830",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.