Thakkar S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036100883 Issued in IL

Legal business name

THAKKAR S.C.

Practice address

2015 Dean St
#2
St Charles, IL 60174-1577

Phone

(630) 584-2400

Fax

(630) 584-2404

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jay Thakkar, M.D.

Title

President

Phone

(630) 584-2400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1801915616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 DEAN ST",
            "address_2": "#2",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741577",
            "telephone_number": "630-584-2400",
            "fax_number": "630-584-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 DEAN ST",
            "address_2": "#2",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741577",
            "telephone_number": "630-584-2400",
            "fax_number": "630-584-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THAKKAR S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "THAKKAR",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-584-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036100883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.