Tomera, Mark
Tomera, Mark is an sole proprietor health care provider with primary practice located at 7579 Lake St , River Forest IL 60305-1846. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Tomera, Mark can be contacted via phone (708) 366-7177.Contact Information
Primary practice address
7579 Lake St
River Forest IL 60305-1846
Phone: (708) 366-7177
Fax: (708) 366-3301
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036065652 | Illinois |
Profile Details
NPI number | 1043311665 |
---|---|
LBN Legal business name | Tomera, Mark |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 26th, 2006 |
Last updated | Jul 1st, 2008 - about 16 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 | 1043311665 | NPPES |
Illinois | MEDICAID | 036065652 | |
Illinois | Other | 31603127 |
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