Individual
DR. THOMAS CROSBY LISKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
831 SANDHURST DR STE 2, SANDWICH, IL 60548-1186
(815) 786-3060
(815) 786-8701
Mailing address
831 SANDHURST DR, SUITE 2, SANDWICH, IL 60548-1390
(815) 786-3060
(815) 786-8701
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036042901
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932096
BC/BS
IL
01
—
207RP1001X
TAXONOMY
IL
05
—
3
—
IL
Enumeration date
03/07/2006
Last updated
12/20/2011
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