Provider Demographics
NPI:1760597595
Name:ESSIG, THOMAS N (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:N
Last Name:ESSIG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 170TH ST
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1451
Mailing Address - Country:US
Mailing Address - Phone:708-335-1415
Mailing Address - Fax:708-335-0115
Practice Address - Street 1:1816 170TH ST
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1451
Practice Address - Country:US
Practice Address - Phone:708-335-1415
Practice Address - Fax:708-335-0115
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700019312251X0800X
IL0960001312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
446430Medicare ID - Type Unspecified