MEDICARE: THOMAS W SWEDER MD SC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1285737742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS W SWEDER MD SC

Provider Business Mailing Address
First Line	:	5701 N ASHLAND
Second Line	:	SUITE 304
City	:	CHICAGO
State	:	IL
Zip	:	60660
Country	:	US
Telephone Number	:	773-878-4740
Fax Number	:	501-643-4785

Provider Business Practice Location Address
First Line	:	5701 N ASHLAND
Second Line	:	SUITE 304
City	:	CHICAGO
State	:	IL
Zip	:	60660
Country	:	US
Telephone Number	:	773-878-4740
Fax Number	:	501-643-4785

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS WILLIAM SWEDER
Credential	:	MD
Telephone Number	:	773-878-4740

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	02/07/2008

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