Healthcare Provider Details

I. General information

NPI: 1619357639
Provider Name (Legal Business Name): THOMAS PETER COURI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 01/11/2024
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1243 RICKERT DR
NAPERVILLE IL
60540-0954
US

IV. Provider business mailing address

1243 RICKERT DR
NAPERVILLE IL
60540-0954
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-6450
  • Fax:
Mailing address:
  • Phone: 630-527-6450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036149580
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125066952
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: