Provider Demographics
NPI:1285674473
Name:VESCIO, THOMAS M (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:VESCIO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:765 CITADEL CT
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6489
Mailing Address - Country:US
Mailing Address - Phone:847-699-6544
Mailing Address - Fax:847-556-1611
Practice Address - Street 1:2050 CLAIRE COURT
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7635
Practice Address - Country:US
Practice Address - Phone:847-467-7423
Practice Address - Fax:847-556-1611
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG30444Medicare UPIN