Provider Demographics
NPI:1518905819
Name:DISCHER, THOMAS JOHN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:DISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S HIGHLAND AVE
Mailing Address - Street 2:SUITE B202 ATTN JAN LEWIS
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6153
Mailing Address - Country:US
Mailing Address - Phone:630-268-1102
Mailing Address - Fax:630-268-1125
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:NORTH ENTRANCE
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-510-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084817207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
060070203OtherRAILROAD MEDICARE
IL036084817Medicaid
ILL96221Medicare ID - Type UnspecifiedLOC 99
IL203058Medicare ID - Type UnspecifiedLOC 15