Cornwell, Thomas A

Cornwell, Thomas A is an individual health care provider with primary practice located at 1800 N Main St Second Floor, Wheaton IL 60187-3112. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Cornwell, Thomas A can be contacted via phone (630) 614-4960.

Contact Information

Primary practice address
1800 N Main St Second Floor Wheaton IL 60187-3112
Phone: (630) 614-4960
Fax: (630) 682-3727
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036075646 Illinois
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 036075646 Illinois

Profile Details

NPI number 1386679082
LBN Legal business name Cornwell, Thomas A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Feb 27th, 2014 - about 12 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 1386679082 NPPES
Illinois MEDICAID 036075646
Illinois Other L66622
Illinois Other P00996567

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