Provider Demographics
NPI:1851474753
Name:CARVER, THOMAS R (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:R
Last Name:CARVER
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 1:1S132 SUMMIT AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3942
Mailing Address - Country:US
Mailing Address - Phone:630-627-4954
Mailing Address - Fax:630-527-0441
Practice Address - Street 1:1S132 SUMMIT AVE STE 305
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3942
Practice Address - Country:US
Practice Address - Phone:630-627-4954
Practice Address - Fax:630-527-0441
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1615022OtherBCBS ID #
ILD16591Medicare UPIN
ILL16121Medicare PIN
IL1615022OtherBCBS ID #