Individual
DR. NEIL J. THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 E MASON ST STE 4P57, SPRINGFIELD, IL 62701
(217) 788-0706
(217) 525-2535
Mailing address
619 E MASON ST STE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
68522
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077558
—
IL
05
—
200469730
—
IN
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147018
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P01090249
MEDICARE RAILROAD PTAN
IL
Enumeration date
08/19/2005
Last updated
10/26/2018
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