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General NPI Number Information
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NPI Number | 1346349974
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Entity Type | Organization
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Legal Business Name | THOMAS J HABERKAMP M D S C
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST SUITE 938
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-942-9980
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Fax | 312-942-9970
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Provider Business Mailing Address
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Address Line | 777 OAKMONT LN SUITE 1600
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City | WESTMONT
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State | IL
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Zip | 60559-5511
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Country | US
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Telephone | 630-789-2550
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | THOMAS J HABERKAMP
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Credential | MD
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Telephone | 312-942-9980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | IL
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