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NPI Code Detail

MEDICARE: DR. THOMAS CARL CARR DPM

MEDICARE: DR. THOMAS CARL CARR DPM
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
1213E00000XPodiatrist016004401IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
160010789OTHERILBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316932668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS CARL CARR DPM
Provider Business Mailing Address
First Line : 467 W ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5704
Country : US
Telephone Number : 312-337-9900
Fax Number : 312-337-9902
Provider Business Practice Location Address
First Line : 467 W ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5704
Country : US
Telephone Number : 312-337-9900
Fax Number : 312-337-9902
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 02/12/2013

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