Basic Information
| Provider Information | |||||||||
| NPI: | 1073702361 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHWEH | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | ANDREW | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 W NORTH AVE | ||||||||
| Address2: | HOSPITALISTS | ||||||||
| City: | MELROSE PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601601612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086813200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 205 PARKER ST | ||||||||
| Address2: | |||||||||
| City: | BOSCOBEL | ||||||||
| State: | WI | ||||||||
| PostalCode: | 538051642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6083754112 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2007 | ||||||||
| LastUpdateDate: | 06/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 11579 | ND | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 036.119301 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 748 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 036.119301 | 01 | IL | MEDICAL LICENSE | OTHER |