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General NPI Number Information
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NPI Number | 1952505190
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Entity Type | Organization
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Legal Business Name | THOMAS VALENTE M.D., P.A.
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 4200 N MARINE DR 1106
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City | CHICAGO
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State | IL
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Zip | 60613-1743
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Country | US
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Telephone | 773-296-4055
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Fax | 773-296-4055
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Provider Business Mailing Address
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Address Line | 4200 N MARINE DR 1106
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City | CHICAGO
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State | IL
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Zip | 60613-1743
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Country | US
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Telephone | 773-296-4055
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Fax | 773-296-4055
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS JOSEPH VALENTE
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Credential | M.D.
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Telephone | 773-296-4055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | IL
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