Physician Compare National (NPI:1407994213)

HEALTHCARE PROVIDER: FRED M TOMERA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407994213
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204097504
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120413000043
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TOMERA
	Individual professional last name
Provider First Name	FRED
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7579 LAKE ST
	Group Practice or individual's line 1 address
City	RIVER FOREST
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	603051846
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7083860284
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140063
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RUSH OAK PARK HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M