Healthcare Provider Details

I. General information

NPI: 1639373228
Provider Name (Legal Business Name): BETSY SUSAN THAMPI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 02/11/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N BARRINGTON RD LOWR LEVEL
HOFFMAN ESTATES IL
60169-1019
US

IV. Provider business mailing address

1555 N BARRINGTON RD LOWR LEVEL
HOFFMAN ESTATES IL
60169-1019
US

V. Phone/Fax

Practice location:
  • Phone: 847-490-4222
  • Fax:
Mailing address:
  • Phone: 847-490-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP1-0017490
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036119533
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: