Healthcare Provider Details

I. General information

NPI: 1407962079
Provider Name (Legal Business Name): THOMAS A HERRIGES M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 AUSTIN ST STE 611
EVANSTON IL
60202-3439
US

IV. Provider business mailing address

800 AUSTIN ST STE 611
EVANSTON IL
60202-3439
US

V. Phone/Fax

Practice location:
  • Phone: 847-869-0437
  • Fax:
Mailing address:
  • Phone: 847-869-0437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: