Thomas J. Boysen, D.P.M., S.C.

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

016002685 Issued in IL

Legal business name

THOMAS J. BOYSEN, D.P.M., S.C.

Practice address

16325 Harlem Ave
Suite 100
Tinley Park, IL 60477-2509

Phone

(708) 444-0646

Fax

(708) 444-1506

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thomas James Boysen, D.P.M.

Title

Owner

Phone

(708) 444-0646

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1801013057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16325 HARLEM AVE",
            "address_2": "SUITE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772509",
            "telephone_number": "708-444-0646",
            "fax_number": "708-444-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16325 HARLEM AVE",
            "address_2": "SUITE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772509",
            "telephone_number": "708-444-0646",
            "fax_number": "708-444-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J. BOYSEN, D.P.M., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "BOYSEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-444-0646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "IL",
            "license": "016002685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NON CORPORATE",
            "identifier": "1336119445",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatric Clinic/Center in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Podiatric Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.