Healthcare Provider Details

I. General information

NPI: 1386221224
Provider Name (Legal Business Name): TITO J THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 877-635-9229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA195294
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036182228
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036182228
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA195294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: