Provider Demographics
NPI:1245579259
Name:TROMPETER, JOHN EDWARD
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EDWARD
Last Name:TROMPETER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E ILLINOIS ST
Mailing Address - Street 2:UNIT L3
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5403
Mailing Address - Country:US
Mailing Address - Phone:630-517-8423
Mailing Address - Fax:630-456-4220
Practice Address - Street 1:211 E ILLINOIS ST
Practice Address - Street 2:UNIT L3
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5403
Practice Address - Country:US
Practice Address - Phone:630-517-8423
Practice Address - Fax:630-456-4220
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000976253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care