Provider Demographics
NPI:1639180045
Name:TPN LTD
Entity Type:Organization
Organization Name:TPN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASSOS
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-774-7224
Mailing Address - Street 1:777 OAKMONT LN
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5511
Mailing Address - Country:US
Mailing Address - Phone:630-789-2550
Mailing Address - Fax:
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 436
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-774-7224
Practice Address - Fax:773-774-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDF0861OtherRAILROAD MEDICARE
IL21602528OtherBCBS PROVIDER ID
IL21602528OtherBCBS PROVIDER ID
ILDF0861OtherRAILROAD MEDICARE