Provider Demographics
NPI:1679781918
Name:PEARSON, WARREN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:THOMAS
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 TECHNY RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5962
Mailing Address - Country:US
Mailing Address - Phone:847-509-2284
Mailing Address - Fax:509-692-2591
Practice Address - Street 1:2625 TECHNY RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5962
Practice Address - Country:US
Practice Address - Phone:847-509-2284
Practice Address - Fax:509-692-2591
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)