Provider Demographics
NPI:1912056284
Name:FOXLAND RESPIRATORY CONSULTANTS, S.C.
Entity Type:Organization
Organization Name:FOXLAND RESPIRATORY CONSULTANTS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CROSBY
Authorized Official - Last Name:LISKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-786-3060
Mailing Address - Street 1:831 SANDHURST DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1186
Mailing Address - Country:US
Mailing Address - Phone:815-786-3060
Mailing Address - Fax:815-786-8701
Practice Address - Street 1:831 SANDHURST DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1186
Practice Address - Country:US
Practice Address - Phone:815-786-3060
Practice Address - Fax:815-786-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3Medicaid
IL1932096OtherBC/BS
IL1790752988OtherTHOMAS C. LISKE NPI #
IL3Medicaid
IL214751Medicare PIN