Diller, Thomas
Diller, Thomas is an individual health care provider with primary practice located at Virginia & Franklin Streets , Normal IL 61761. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Diller, Thomas can be contacted via phone (309) 827-4321.Contact Information
Primary practice address
Virginia & Franklin Streets
Normal IL 61761
Phone: (309) 827-4321
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | Illinois |
Profile Details
| NPI number | 1487682530 |
|---|---|
| LBN Legal business name | Diller, Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487682530 | NPPES |
| Illinois | MEDICAID | 036069717-1 | |
| Illinois | Other | 05721369 |
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