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General NPI Number Information
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NPI Number | 1114817277
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Entity Type | Individual
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Provider Name | THOMAS SVOBODA
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Gender |
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 2600 WARRENVILLE RD STE 212
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1761
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Country | US
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Telephone | 708-792-0162
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Fax |
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Provider Business Mailing Address
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Address Line | 13071 DUNMOOR DR
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City | LEMONT
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State | IL
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Zip | 60439-2741
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Country | US
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Telephone | 708-792-0162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 22-209155
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License Number State | IL
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