Godbout, Thomas G

Godbout, Thomas G is an sole proprietor health care provider with primary practice located at 1352 Patriot Blvd , Glenview IL 60026-7777. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Sports Physician. Chiropractic Providers / Sports Physician is his primary health care specialty. Godbout, Thomas G can be contacted via phone (847) 657-0400.

Contact Information

Primary practice address
1352 Patriot Blvd Glenview IL 60026-7777
Phone: (847) 657-0400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038010264 Illinois
Chiropractic Providers / Sports Physician 111NS0005X 038010264 Illinois

Profile Details

NPI number 1669500104
LBN Legal business name Godbout, Thomas G
Credentials D.C., CCSP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2007
Last updated Aug 26th, 2016 - about 10 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 1669500104 NPPES
Illinois Other K51546 MEDICARE PTAN

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