Provider Demographics
NPI:1134415250
Name:CHIAMPAS, THOMAS DEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DEAN
Last Name:CHIAMPAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 S WOOD ST # MC886
Mailing Address - Street 2:ROOM 164
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7229
Mailing Address - Country:US
Mailing Address - Phone:312-996-0897
Mailing Address - Fax:312-413-1797
Practice Address - Street 1:833 S WOOD ST # MC886
Practice Address - Street 2:ROOM 164
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7229
Practice Address - Country:US
Practice Address - Phone:312-996-0897
Practice Address - Fax:312-413-1797
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051294963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist