Provider Demographics
NPI:1346249679
Name:LINDSTROM, THOMAS JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:LINDSTROM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 W DOWNER PL
Mailing Address - Street 2:STE 201
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-4379
Mailing Address - Country:US
Mailing Address - Phone:630-896-3377
Mailing Address - Fax:630-896-2120
Practice Address - Street 1:1965 W DOWNER PL
Practice Address - Street 2:STE 201
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4379
Practice Address - Country:US
Practice Address - Phone:630-896-3377
Practice Address - Fax:630-896-2120
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-004507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04515187OtherBCBS
IL4532710OtherBCBS
IL350038827OtherRAIL ROAD MEDICARE
IL350038827OtherRAIL ROAD MEDICARE
IL4532710OtherBCBS