Provider Demographics
NPI:1932163037
Name:KASON, THOMAS T (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:T
Last Name:KASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13011 S 104TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1508
Mailing Address - Country:US
Mailing Address - Phone:708-478-3600
Mailing Address - Fax:708-478-3552
Practice Address - Street 1:13011 S 104TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1508
Practice Address - Country:US
Practice Address - Phone:708-274-3278
Practice Address - Fax:708-274-3299
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036105720207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCD8033OtherRAILROAD MEDICARE GROUP N
ILP00229161OtherRAILROAD MEDICARE
IL236551OtherMEDICARE GROUP
IL416810OtherMEDICARE GROUP
ILCN2703OtherRAILROAD MEDICARE GROUP PTAN NUMBER
IL01621208OtherBLUECROSS BLUESHIELD
ILCG1672OtherRAILROAD MEDICARE GROUP N
ILCD8033OtherRAILROAD MEDICARE GROUP PTAN NUMBER
ILCN2703OtherRAILRAOD MEDICARE GROUP
IL036105720Medicaid
IL1508810086OtherGROUP NPI
IL236550OtherMEDICARE GROUP
IL1508810086OtherGROUP NPI
IL416810OtherMEDICARE GROUP
IL236550OtherMEDICARE GROUP
ILCN2703OtherRAILRAOD MEDICARE GROUP