{
"Npi": {
"NPI": "1184879710",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KEANE",
"FirstName": "THOMAS",
"MiddleName": "EARL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "240 E ILLINOIS ST",
"SecondLineMailingAddress": "904",
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60611-5063",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "443-458-2442",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "903 COMMERCE DR",
"SecondLinePracticeLocationAddress": "SUITE 333",
"PracticeLocationAddressCityName": "OAK BROOK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60523-1969",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-458-2442",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/24/2008",
"LastUpdateDate": "04/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "D0068081",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0204X",
"TaxonomyName": "Vascular & Interventional Radiology Physician",
"LicenseNumber": "MD439754",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0204X",
"TaxonomyName": "Vascular & Interventional Radiology Physician",
"LicenseNumber": "D68081",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0204X",
"TaxonomyName": "Vascular & Interventional Radiology Physician",
"LicenseNumber": "233410",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0204X",
"TaxonomyName": "Vascular & Interventional Radiology Physician",
"LicenseNumber": "35.094295",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0204X",
"TaxonomyName": "Vascular & Interventional Radiology Physician",
"LicenseNumber": "77789",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0204X",
"TaxonomyName": "Vascular & Interventional Radiology Physician",
"LicenseNumber": "036126957",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}