Organization
KORATHU THOMAS, MD, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KORATHU THOMAS M.D. (PRESIDENT)
(773) 283-9594
Entity
Organization
Contact information
Practice address
2222 W DIVISION ST, CHICAGO, IL 60622-2717
(773) 227-8870
(312) 770-3208
Mailing address
PO BOX 1201, NORTHBROOK, IL 60065-1201
(773) 283-9594
(773) 283-6711
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
036053507
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053507
—
IL
Enumeration date
02/22/2011
Last updated
02/22/2011
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