MEDICARE: DR. MICHAEL WILLIAM THOMAS O.D.

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	152W00000X	Optometrist	046-009334	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00049324111	OTHER	IL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679539993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL WILLIAM THOMAS O.D.

Provider Business Mailing Address
First Line	:	205 N STATE ST
Second Line	:
City	:	MARENGO
State	:	IL
Zip	:	60152-2239
Country	:	US
Telephone Number	:	815-568-6508
Fax Number	:	815-568-4896

Provider Business Practice Location Address
First Line	:	205 N STATE ST
Second Line	:
City	:	MARENGO
State	:	IL
Zip	:	60152-2239
Country	:	US
Telephone Number	:	815-568-6508
Fax Number	:	815-568-4896

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	08/23/2010

Similar Medicare Providers

1831177088 — DR. JON W RUSSELL O.D.
Practice Location Address:

205 N STATE ST
MARENGO, IL
60152-2239

Practice Phone: 815-568-6508
Practice Fax:

1992736276 — MARENGO VISION CENTER, P.C.
Practice Location Address:

205 N STATE ST
MARENGO, IL
60152-2239

Practice Phone: 815-568-6508
Practice Fax:

1275056236 — JAVIER RAMIRO RODRIGUEZ OD
Practice Location Address:

205 N STATE ST
MARENGO, IL
60152-2239

Practice Phone: 815-568-6508
Practice Fax:

1780789693 — WILLOW OF MARENGO, INC
Practice Location Address:

546 E GRANT HWY
MARENGO, IL
60152-3346

Practice Phone: 815-568-8322
Practice Fax: 815-568-0135

1659373132 — K C A S ENT INC.
Practice Location Address:

706 N TAYLOR ST
MARENGO, IL
60152-2457

Practice Phone: 815-568-0243
Practice Fax: 815-568-5350

1447220470 — DR. PAUL ALLEN MARNUL O.D.
Practice Location Address:

211 S STATE ST
MARENGO, IL
60152-2229

Practice Phone: 815-568-3937
Practice Fax:

Directions to “ DR. MICHAEL WILLIAM THOMAS O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.