Provider Demographics
NPI:1578064317
Name:HILL, THOMAS PATRICK
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:PATRICK
Last Name:HILL
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 1:975 W HAWTHORN DR
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2056
Mailing Address - Country:US
Mailing Address - Phone:800-844-1232
Mailing Address - Fax:
Practice Address - Street 1:740 QUAIL RIDGE DR BLDG D
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6148
Practice Address - Country:US
Practice Address - Phone:630-581-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IL1-23-64190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician