Provider Demographics
NPI:1477716751
Name:PATTON, THOMAS MURRAY
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MURRAY
Last Name:PATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SUNNY HILL CT
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:IL
Mailing Address - Zip Code:61273-9713
Mailing Address - Country:US
Mailing Address - Phone:309-721-5533
Mailing Address - Fax:
Practice Address - Street 1:29W522 BATAVIA RD
Practice Address - Street 2:SUITE #1
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-2007
Practice Address - Country:US
Practice Address - Phone:309-721-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.005623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional