Berry, Thomas L

Berry, Thomas L is an individual health care provider with primary practice located at 7850 W College Dr , Palos Heights IL 60463-1010. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Berry, Thomas L can be contacted via phone (708) 361-6990.

Contact Information

Primary practice address
7850 W College Dr Palos Heights IL 60463-1010
Phone: (708) 361-6990
Fax: (708) 361-7697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209-005729 Illinois

Profile Details

NPI number 1104830876
LBN Legal business name Berry, Thomas L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Sep 13th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104830876 NPPES
Illinois MEDICAID 209005729
Illinois Other P00792110

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