Individual
DAVID THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 362-2900
Mailing address
PO BOX 703, TRAVERSE CITY, MI 49685-0703
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-093858
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093858
—
IL
05
—
0360938583
—
IL
Enumeration date
07/17/2006
Last updated
12/15/2021
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