Individual
THOMAS A. EISEMAN
Active
Individual
THOMAS A. EISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036102548
IL
207R00000X
Internal Medicine Physician
036102548
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP ID
IL
05
—
036102548
—
IL
01
—
1033149844
GROUP NPI
IL
01
—
206147
MEDICARE GROUP PTAN
IL
01
—
3631498336019001
HFS GROUP PAYEE ID
IL
01
—
CA4748
MEDICARE RAILROAD PTAN (GROUP)
—
01
—
P00884750
MEDICARE RAILROAD PTAN (INDIVIDUAL)
—
Enumeration date
08/09/2005
Last updated
08/16/2017
Update your record
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