Heroldt, Thomas

Heroldt, Thomas is an sole proprietor health care provider with primary practice located at 600 Spring Hill Ring Rd Ste 105 , West Dundee IL 60118-7301. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Heroldt, Thomas can be contacted via phone (312) 513-3702.

Contact Information

Primary practice address
600 Spring Hill Ring Rd Ste 105 West Dundee IL 60118-7301
Phone: (312) 513-3702
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180004128 Illinois

Profile Details

NPI number 1376656884
LBN Legal business name Heroldt, Thomas
Credentials MA,LCPC,CADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2006
Last updated Apr 12th, 2019 - about 7 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 1376656884 NPPES
Illinois Other 0081646690 BCBS

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