Organization
MEDVENTURES MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS C. LISKE MD,F.C. C.P. (DOCTOR)
(815) 786-3060
Entity
Organization
Contact information
Practice address
225 EDWARD ST, SYCAMORE, IL 60178-2137
(815) 786-3060
(815) 786-8701
Mailing address
831 SANDHURST DR, SUITE 2, SANDWICH, IL 60548-1186
(815) 786-3060
(815) 786-8701
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
IL
01
—
1790752988
DR. THOMAS LISKE NPI #
IL
01
—
1912056284
FOXLAND RESPIRATORY NPI #
IL
01
—
1932096
BC/BS
IL
Enumeration date
03/01/2007
Last updated
01/23/2008
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