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NPI Code Detail

MEDICARE: MR. ROBERT F THOMANN PA-C

MEDICARE: MR. ROBERT F THOMANN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085.002298IL
2363AM0700XMedical Physician Assistant085-002298IL
3363AS0400XSurgical Physician Assistant085002298IL

General Provider Information

NPI Number : 1114914199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT F THOMANN PA-C
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-570-2040
Fax Number :
Provider Business Practice Location Address
First Line : 5145 N CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3661
Country : US
Telephone Number : 773-989-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 04/21/2025

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Directions to “ MR. ROBERT F THOMANN PA-C” Practice Location

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