Provider Demographics
NPI:1407023146
Name:KRAMER, THOMAS ANDREW MOSS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREW MOSS
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:195 N HARBOR DR
Mailing Address - Street 2:#202
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7514
Mailing Address - Country:US
Mailing Address - Phone:847-509-0076
Mailing Address - Fax:
Practice Address - Street 1:195 N HARBOR DR
Practice Address - Street 2:#202
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7514
Practice Address - Country:US
Practice Address - Phone:847-509-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1041962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B00231Medicare UPIN