Individual
WILLIAM H THOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 MAPLE SUMMIT RD, PAIN CENTER, JERSEYVILLE, IL 62052
(618) 498-2273
(618) 498-8316
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-7518
(618) 498-3052
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036.118645
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
2004005755
MO
208VP0000X
Pain Medicine Physician
036118645
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036118645
IL LICENSE
IL
01
—
08220357
BCBS GRP#
IL
05
—
255414300
—
MN
01
—
752332
HEALTHLINK
IL
01
—
900068033
TAX-ID#
IL
Enumeration date
12/29/2005
Last updated
11/13/2024
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