Gavin, Thomas

Gavin, Thomas is an sole proprietor health care provider with primary practice located at 1010 Jorie Blvd Ste 24 , Oak Brook IL 60523-4450. He recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as his primary health care specialty. Gavin, Thomas can be contacted via phone (630) 573-7777.

Contact Information

Primary practice address
1010 Jorie Blvd Ste 24 Oak Brook IL 60523-4450
Phone: (630) 573-7777
Fax: (630) 573-4424
Website:
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Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1114580107
LBN Legal business name Gavin, Thomas
Credentials CO/LO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 16th, 2019
Last updated Apr 16th, 2019 - about 5 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 1114580107 NPPES
Other NONE NONE

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