Provider Demographics
NPI:1568460970
Name:PATTERSON, THOMAS H (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:H
Last Name:PATTERSON
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 1:834 N SEMINARY ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2852
Mailing Address - Country:US
Mailing Address - Phone:309-343-2262
Mailing Address - Fax:309-343-2081
Practice Address - Street 1:834 N SEMINARY ST
Practice Address - Street 2:SUITE 502
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2852
Practice Address - Country:US
Practice Address - Phone:309-343-2262
Practice Address - Fax:309-343-2081
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-065538208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL034041OtherHEALTH ALLIANCE PROV #
IL04823538OtherBCBS GROUP #
IL689572OtherHEALTHLINK PROV #
IL036065538Medicaid
IL340017812OtherRR MEDICARE PROV #
ILIL0101OtherJOHN DEERE PROV #
ILB02982Medicare UPIN
IL689572OtherHEALTHLINK PROV #