Healthcare Provider Details

I. General information

NPI: 1891998019
Provider Name (Legal Business Name): TODD TOMSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1295
US

IV. Provider business mailing address

351 DELNOR DR STE 302
GENEVA IL
60134-4233
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-0280
  • Fax: 630-315-1469
Mailing address:
  • Phone: 630-202-0280
  • Fax: 630-315-1469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number036130071
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036.130071
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: