Provider Demographics
NPI:1316165475
Name:BILLINGSLEY, JOSHUA THOMAS (MD)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:THOMAS
Last Name:BILLINGSLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:1700 LUTHER LANE
Practice Address - Street 2:SUITE 1170
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:844-376-3876
Practice Address - Fax:847-723-2041
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116821207T00000X
NC2016-00369207T00000X
IL036-130002207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009939100Medicaid
FLHP703XOtherMEDICARE-UNIVERSITY OF FLORIDA HEALTH
FLHP703XOtherMEDICARE-UNIVERSITY OF FLORIDA HEALTH