Provider Demographics
NPI:1295244465
Name:THURMOND, TODD CHRISTOPHER JR
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:CHRISTOPHER
Last Name:THURMOND
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 TIMBER RIDGE DR APT 104C
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2850
Mailing Address - Country:US
Mailing Address - Phone:630-234-0054
Mailing Address - Fax:
Practice Address - Street 1:532 TIMBER RIDGE DR APT 104C
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2850
Practice Address - Country:US
Practice Address - Phone:630-234-0054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer