Provider Demographics
NPI:1356086607
Name:CHEMPLAVIL, TOBIN JOHNSON (DO)
Entity Type:Individual
Prefix:DR
First Name:TOBIN
Middle Name:JOHNSON
Last Name:CHEMPLAVIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5427 SILK OAK DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5005
Mailing Address - Country:US
Mailing Address - Phone:630-303-4535
Mailing Address - Fax:
Practice Address - Street 1:7702 N ALPINE RD
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-3107
Practice Address - Country:US
Practice Address - Phone:815-971-3397
Practice Address - Fax:815-971-9795
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program