MEDICARE: ANTHONY THOMAS MD

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
1	207P00000X	Emergency Medicine Physician	125087751	IL

General Provider Information

NPI Number	:	1134964174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY THOMAS MD

Provider Business Mailing Address
First Line	:	PO BOX 19679
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62794-9679
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-2711

Provider Business Practice Location Address
First Line	:	701 N 1ST ST STE D220
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62702-3757
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-2711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	06/01/2026

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