Organization
THOMAS G. SALVI, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS G. SALVI MD (PHYSICIAN OWNER)
(224) 333-0928
Entity
Organization
Contact information
Practice address
1106 N MAIN ST, ALGONQUIN, IL 60102-3482
(815) 353-2601
Mailing address
1106 N MAIN ST, ALGONQUIN, IL 60102-3482
(224) 333-0928
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036085984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085984
—
IL
01
—
336.048074
CONTROLLED SUBSTANCE LICENSE NUMBER
IL
Enumeration date
01/25/2018
Last updated
01/31/2018
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