Provider Demographics
NPI:1659597466
Name:TOUMA, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:TOUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E CHICAGO AVE
Mailing Address - Street 2:SUITE 1050
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2637
Mailing Address - Country:US
Mailing Address - Phone:312-944-6677
Mailing Address - Fax:312-944-3346
Practice Address - Street 1:211 E CHICAGO AVE
Practice Address - Street 2:SUITE 1050
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2637
Practice Address - Country:US
Practice Address - Phone:312-944-6677
Practice Address - Fax:312-944-3346
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00443207R00000X
IL036120532207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine