Individual
DR. THOMAS L. MICHALSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
406 S 5TH ST, KIRKLAND, IL 60146-7711
(815) 522-3301
(815) 522-3855
Mailing address
1713 OAKWOOD GLEN CLOSE, ROCKFORD, IL 61108-7011
(815) 332-4660
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036066772
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036066772
STATE LICENSE
IL
Enumeration date
07/19/2006
Last updated
08/22/2022
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