Provider Demographics
NPI:1275816886
Name:SAVAGE, THOMAS M
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:M
Last Name:SAVAGE
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 1:7945 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2229
Mailing Address - Country:US
Mailing Address - Phone:708-599-5603
Mailing Address - Fax:708-599-7848
Practice Address - Street 1:7945 W 95TH ST
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2229
Practice Address - Country:US
Practice Address - Phone:708-599-5603
Practice Address - Fax:708-599-7848
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.032396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist