Active NPI
Tara Thananetapon Alaichamy, D.P.T.
- Physical Therapist
- Zion, IL
National Provider Identifier
1699063222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P12259
- Practice address
- 2520 Elisha Avenue
Zion, IL 60099 - Phone
- (847) 731-1605
- Fax
- (847) 872-6176
- NPI assigned
- Jul 18, 2011
- Last updated
- Mar 27, 2018
- Sex
- Female
- 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 | P12259 | NC | Primary |
Addresses
Primary practice location
2520 Elisha Avenue
Zion, IL 60099
Mailing address
2610 Sheridan Road
Zion, IL 60099
Phone (877) 884-7346
Other names 1
- Miss Tara Thananetapon
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P12259 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522108800000",
"number": "1699063222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 SHERIDAN ROAD",
"city": "ZION",
"state": "IL",
"postal_code": "60099",
"telephone_number": "877-884-7346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 ELISHA AVENUE",
"city": "ZION",
"state": "IL",
"postal_code": "60099",
"telephone_number": "847-731-1605",
"fax_number": "847-872-6176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALAICHAMY",
"first_name": "TARA",
"middle_name": "THANANETAPON",
"name_prefix": "Mrs.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-18",
"last_updated": "2018-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P12259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TARA",
"last_name": "THANANETAPON",
"prefix": "MISS",
"credential": "D.P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Zion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.