Healthcare Provider Details

I. General information

NPI: 1194797266
Provider Name (Legal Business Name): THOMAS L. CAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: THOMAS LEQUN CAO

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 NORTH RANDALL ROAD SUITE 402
ELGIN IL
60123
US

IV. Provider business mailing address

1600 N RANDALL RD STE 135
ELGIN IL
60123-7810
US

V. Phone/Fax

Practice location:
  • Phone: 847-717-6860
  • Fax: 847-717-6872
Mailing address:
  • Phone: 847-717-6860
  • Fax: 847-717-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036098274
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: