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General NPI Number Information
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NPI Number | 1386679082
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Entity Type | Individual
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Provider Name | THOMAS A CORNWELL MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1800 N MAIN ST SECOND FLOOR
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City | WHEATON
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State | IL
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Zip | 60187-3112
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Country | US
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Telephone | 630-614-4960
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Fax | 630-682-3727
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Provider Business Mailing Address
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Address Line | 1800 N MAIN ST SECOND FLOOR
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City | WHEATON
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State | IL
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Zip | 60187-3112
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Country | US
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Telephone | 630-614-4960
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Fax | 630-682-3727
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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 | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 036075646
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036075646
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License Number State | IL
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