Individual
THOMAS A. MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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