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David T Thom
Student in an Organized Health Care Education/Training Program in Johnsburg, Illinois
NPI 1902484405

David T Thom is a Student in an Organized Health Care Education/Training Program based in Rockford, IL. David T Thom practices in Johnsburg, IL. The NPI Number for David T Thom is 1902484405 and holds a License No. (Illinois).

The current practice location address for David T Thom is 2326 West Fairview Avenue, Johnsburg, IL and can be reached out via phone at 815-679-8820.

Location: 2326 West Fairview Avenue, Johnsburg, IL, 61108-2425
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902484405
Provider Name
David T Thom
Credential
Provider Entity Type
Individual
Gender
Male
Address
2326 West Fairview Avenue, Johnsburg, IL, 61108-2425
Phone Number
815-679-8820
Fax Number
Provider Enumeration Date
03/29/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2326 West Fairview Avenue
City
Johnsburg
State
Illinois
Zip
60051
Phone Number
815-679-8820
Fax Number
person
Provider Business Mailing Address Details
Address
2326 West Fairview Avenue
City
Johnsburg
State
Illinois
Zip
60051
Phone Number
815-679-8820
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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