Active NPI
Tom Joseph Tierney, P.T.
- Physical Therapist
- Burr Ridge, IL
National Provider Identifier
1912020801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 70005016
- Practice address
- 8236 S Madison St
Burr Ridge, IL 60527-5811 - Phone
- (630) 321-1717
- Fax
- (630) 321-1711
- NPI assigned
- Apr 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 70005016 | IL | Primary |
Addresses
Primary practice location
8236 S Madison St
Burr Ridge, IL 60527-5811
Mailing address
4 Yellow Star CT
Woodridge, IL 60517-1702
Phone (630) 960-0783
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 |
|---|---|---|---|
| 70005016 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912020801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 YELLOW STAR CT",
"city": "WOODRIDGE",
"state": "IL",
"postal_code": "605171702",
"telephone_number": "630-960-0783",
"fax_number": "630-321-1711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8236 S MADISON ST",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605275811",
"telephone_number": "630-321-1717",
"fax_number": "630-321-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIERNEY",
"first_name": "TOM",
"middle_name": "JOSEPH",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "70005016",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.