Healthcare Provider Details

I. General information

NPI: 1285621219
Provider Name (Legal Business Name): THOMAS JOSEPH SINGEL II DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PINE CT
LAKE BLUFF IL
60044-2435
US

IV. Provider business mailing address

500 PINE CT
LAKE BLUFF IL
60044-2435
US

V. Phone/Fax

Practice location:
  • Phone: 847-735-9553
  • Fax:
Mailing address:
  • Phone: 847-735-9553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036088528
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: