Provider Demographics
NPI:1003000134
Name:CIBULL, THOMAS LEE (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:CIBULL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-2040
Mailing Address - Fax:847-733-5315
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:EVANSTON HOSPITAL
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-570-2040
Practice Address - Fax:847-733-5315
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2008-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036120492207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology