MEDICARE: THOMAS F KANNIN 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	207R00000X	Internal Medicine Physician	036086448	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235132952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS F KANNIN MD

Provider Business Mailing Address
First Line	:	6954 W TOUHY AVE STE 101
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-4535
Country	:	US
Telephone Number	:	847-647-1771
Fax Number	:	847-647-5981

Provider Business Practice Location Address
First Line	:	6954 W TOUHY AVE STE 101
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-4535
Country	:	US
Telephone Number	:	847-647-1771
Fax Number	:	847-647-5981

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/10/2022

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Directions to “ THOMAS F KANNIN MD” Practice Location

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