Provider Demographics
NPI:1609072883
Name:MEERSMAN, THOMAS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:MEERSMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 DOWNING PL
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3487
Mailing Address - Country:US
Mailing Address - Phone:847-989-5676
Mailing Address - Fax:
Practice Address - Street 1:618 MANOMET CT
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4727
Practice Address - Country:US
Practice Address - Phone:847-882-2030
Practice Address - Fax:847-294-1954
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
IL085-002872363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085-002872OtherLICENSE NUMBER
ILMM1590884OtherDEA