Dr Nicholas M Tabor III DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

DR NICHOLAS M TABOR III DPM

Practice address

226 Marquette St
La Salle, IL 61301-2415

Phone

(815) 224-3535

Fax

(815) 224-5750

NPI assigned

Feb 29, 2008

Last updated

Feb 29, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

DR NICHOLAS M TABOR III DPMAs reported in NPPES

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

Authorized official

Name

Dr. Nicholas M Tabor III, DPMNPI 1255327441

Title

Owner

Phone

(815) 224-3535

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Part of

Dr Nicholas M Tabor III DPM

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas M Tabor III, DPM

  • Podiatrist
  • La Salle, IL
  • NPI 1255327441
  NPD Authorized official

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1912176306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MARQUETTE ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012415",
            "telephone_number": "815-224-3535",
            "fax_number": "815-224-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MARQUETTE ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012415",
            "telephone_number": "815-224-3535",
            "fax_number": "815-224-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR NICHOLAS M TABOR III DPM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR NICHOLAS M TABOR III DPM",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "TABOR",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-224-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryfrances Crist, APN
• Elizabeth M Davis, LCSW
• John James Derango, DDS
• Jessica Marie Dergance, LCSW
• Dimmick CC School Dist 175
• Dr William White PC
• Karen R. Dunne, M.S.,CCC
• Edward J Fesco MD SC
• Christine Eimer
• Diane Louise Farrell, LCSW

• Podiatrist in La Salle, IL
• Providers in La Salle, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.