Provider Demographics
NPI:1134241466
Name:NOTTINGHAM, THOMAS K (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:K
Last Name:NOTTINGHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:KENT
Other - Last Name:NOTTINGHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD STE 301N
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1266
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-468-1836
Practice Address - Street 1:14300 CLAY TERRACE BLVD STE 241S
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3636
Practice Address - Country:US
Practice Address - Phone:317-818-0940
Practice Address - Fax:317-288-5481
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000840-A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INT34518Medicare UPIN
IN201810AMedicare ID - Type UnspecifiedMEDICARE