Hazel, Thomas R.

Hazel, Thomas R. is an individual health care provider with primary practice located at 2425 Fargo Blvd , Geneva IL 60134-3591. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hazel, Thomas R. can be contacted via phone (630) 232-2200.

Contact Information

Primary practice address
2425 Fargo Blvd Geneva IL 60134-3591
Phone: (630) 232-2200
Fax: (630) 232-1940
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036077708 Illinois

Profile Details

NPI number 1730189176
LBN Legal business name Hazel, Thomas R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Dec 19th, 2012 - 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 1730189176 NPPES
Illinois MEDICAID 036077708

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