Provider Demographics
NPI:1336141746
Name:FICHO, THOMAS (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:FICHO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 COMPASS RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8000
Mailing Address - Country:US
Mailing Address - Phone:847-998-0010
Mailing Address - Fax:847-998-1171
Practice Address - Street 1:2501 COMPASS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8000
Practice Address - Country:US
Practice Address - Phone:847-998-0010
Practice Address - Fax:847-998-1171
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036065619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC45965Medicare UPIN
ILIL1254001Medicare PIN
IL721701Medicare ID - Type Unspecified