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:
Health care specialties
Specialty | Code | License # | 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 13 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 | 1730189176 | NPPES |
Illinois | MEDICAID | 036077708 |
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