Thomas J. Mack

NPI 1245415850 - Podiatrist - 213E00000X

NPI Details
NPI 1245415850
Enumeration Date 01/02/2008
Last Updated 06/13/2013
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name THOMAS J. THOMAS
Position OWNER
Phone (708) 387-0633
Fax (708) 387-0638
Practice Location
3704 GRAND BLVD
BROOKFIELD IL, 60513-1624, US
Phone (708) 387-0633
Fax (708) 387-0638
Business Location
3704 GRAND BLVD
BROOKFIELD IL, 60513-1624, US
Phone
Fax
Toxanomy
Taxonomy Code 213E00000X
License State Illinois
License Number 016003689
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According to our database, Thomas J. Mack NPI is 1245415850, taxonomy code is 213E00000X and license number is 016003689, license state is located at Illinois. Thomas J. Mack physically located at 3704 Grand Blvd, Brookfield IL, 60513-1624. NPI Number 1033115704 has the healthcare provider type.

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1245415850 NPI number is provided on an as is basis without warranty of any kind. 1245415850 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas J. Mack are for informational purposes only.