Provider Demographics
NPI:1598759680
Name:BURNSTINE, THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:BURNSTINE
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:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60065-0187
Mailing Address - Country:US
Mailing Address - Phone:847-968-5700
Mailing Address - Fax:847-816-3212
Practice Address - Street 1:755 S MILWAUKEE AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3253
Practice Address - Country:US
Practice Address - Phone:847-816-0500
Practice Address - Fax:847-816-3212
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36795332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology