Individual
THOMAS G DE TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
305 W JACKSON ST STE 206, CARBONDALE, IL 62901-1474
(618) 457-3006
(618) 457-3007
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5467
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000963
IL
Other
Enumeration date
11/21/2006
Last updated
10/01/2025
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