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Individual

THOMAS A. MAYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2151 WAUKEGAN RD STE 100, BANNOCKBURN, IL 60015
(847) 444-5300
(847) 267-1429
Mailing address
2151 WAUKEGAN RD STE 100, BANNOCKBURN, IL 60015-1885
(847) 444-5300
(847) 267-1429

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36069502
IL
207RC0000X
Cardiovascular Disease Physician
36069502
IL
207RI0011X
Interventional Cardiology Physician
Primary
36069502
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04915267
BLUE CROSS BLUE SHIELD
IL
01
110047112
RAILROAD MEDICARE
IL
05
36069502
IL
01
K04929
MEDICARE PIN LOCALITY 16
IL
01
L01384
MEDICARE PIN LOCALITY 15
IL
Enumeration date
07/20/2006
Last updated
10/06/2020
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