Organization
THOMAS TILOT MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS TILOT M.D (PRESIDENT)
(815) 385-1101
Entity
Organization
Contact information
Practice address
5435 BULL VALLEY RD, SUITE 200, MCHENRY, IL 60050-7434
(815) 385-1101
(815) 385-6953
Mailing address
5435 BULL VALLEY RD, SUITE 200, MCHENRY, IL 60050-7434
(815) 385-1101
(815) 385-6953
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
036093581
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093581
—
IL
01
—
5632348
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/01/2008
Last updated
04/09/2009
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