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Mr. Thomas Gavin, CO/LO
Prosthetic/Orthotic Supplier in Oak Brook, Illinois
NPI 1114580107

Thomas Gavin is a Prosthetic/Orthotic Supplier based in Oak Brook, IL. Thomas Gavin practices in Oak Brook, IL and has the professional credentials of CO/LO. The NPI Number for Thomas Gavin is 1114580107 and holds a License No. (Illinois).

The current practice location address for Thomas Gavin is 1010 Jorie Blvd Ste 24, Oak Brook, IL and can be reached out via phone at 630-573-7777 and via fax at 630-573-4424.

Location: 1010 Jorie Blvd Ste 24, Oak Brook, IL, 60523-4450
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114580107
Provider Name
Thomas Gavin
Credential
CO/LO
Provider Entity Type
Individual
Gender
Male
Address
1010 Jorie Blvd Ste 24, Oak Brook, IL, 60523-4450
Phone Number
630-573-7777
Fax Number
630-573-4424
Provider Enumeration Date
04/16/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NONE 01 NONE
institution
Provider Business Practice Location Address Details
Address
1010 Jorie Blvd Ste 24
City
Oak Brook
State
Illinois
Zip
60523-4450
Phone Number
630-573-7777
Fax Number
630-573-4424
person
Provider Business Mailing Address Details
Address
1010 Jorie Blvd Ste 24
City
Oak Brook
State
Illinois
Zip
60523-4450
Phone Number
630-573-7777
Fax Number
630-573-4424
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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