Provider Demographics
NPI:1700932902
Name:LOUISE C. TOMKINS MD PC
Entity Type:Organization
Organization Name:LOUISE C. TOMKINS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:COLLUMS
Authorized Official - Last Name:TOMKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-256-9199
Mailing Address - Street 1:444 SKOKIE BLVD
Mailing Address - Street 2:360
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3086
Mailing Address - Country:US
Mailing Address - Phone:847-256-9199
Mailing Address - Fax:847-835-5038
Practice Address - Street 1:444 SKOKIE BLVD
Practice Address - Street 2:360
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-3086
Practice Address - Country:US
Practice Address - Phone:847-256-9199
Practice Address - Fax:847-835-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060003762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC45289Medicare UPIN
IL661470Medicare ID - Type Unspecified