MEDICARE: THOMAS PATRICK CARMODY 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	036-099110	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	:	1275534406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS PATRICK CARMODY MD

Provider Business Mailing Address
First Line	:	PO BOX 95279
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60694-5279
Country	:	US
Telephone Number	:	877-485-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 HIGHLAND AVE
Second Line	:	ADVOCATE GOOD SAMARITAN HOSPITAL
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1500
Country	:	US
Telephone Number	:	630-275-5900
Fax Number	:	630-734-1560

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/18/2022

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