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Individual

DR. THOMAS BUMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3545 W 95TH ST, EVERGREEN PARK, IL 60805-2135
(708) 346-5562
(708) 346-2059
Mailing address
3545 W 95TH ST, EVERGREEN PARK, IL 60805-2135
(708) 346-5562
(708) 346-2059

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-062686
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036-062686
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001619074
BROUP BC/BS#
05
036062686
IL
01
1477731685
GROUP NPI#
IL
01
1619991361
GROUP NPI#
IL
01
203979007
MEDICARE PTAN-SPI
IL
01
685583
GROUP MEDICARE#
01
IL4013007
MEDICARE PTAN#
IL
01
IL4014007
MEDICARE PTAN#
IL
01
P00713296/CK6882
MEDICARE RAILROAD
IL
Enumeration date
07/10/2006
Last updated
12/20/2021
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