Individual
TADANORI TOMITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 N CHILDRENS PLZ, CHICAGO, IL 60614-3363
(773) 880-4000
(773) 281-1576
Mailing address
35422 EAGLE WAY, CHICAGO, IL 60678-0001
(773) 880-4000
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036061591
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061591
—
IL
05
—
0563684
—
IA
01
—
1627123
BCBS PROVIDER ID
IL
01
—
7618592
GHI PROVIDER ID
IL
05
—
8023632
—
WA
Enumeration date
09/21/2005
Last updated
03/11/2008
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