Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 016005762 | IL |
N | 222Z00000X | Podiatrist | 016005762 | IL |
N | 213EP1101X | Primary Podiatric Medicine | 016005762 | IL |
N | 111NR0200X | Radiology | 016005762 | IL |
N | 213ER0200X | Radiology | 016005762 | IL |
N | 2081S0010X | Sports Medicine | 016005762 | IL |
N | 213ES0000X | Sports Medicine | 016005762 | IL |
Y | 213ES0103X | Foot & Ankle Surgery | 016005762 | IL |
N | 213ES0131X | Foot Surgery | 016005732 | IL |
NPI | 1023470754 |
---|---|
Provider Name | Dr. Thomas Scott Nordquist |
First Address | Sycamore, IL 60178-3122 |
Second Address | Sycamore, IL 60178-3122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 17/03/2018 |