Basic Information
| Provider Information | |||||||||
| NPI: | 1356086607 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEMPLAVIL | ||||||||
| FirstName: | TOBIN | ||||||||
| MiddleName: | JOHNSON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5427 SILK OAK DR | ||||||||
| Address2: | |||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605645005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303034535 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7702 N ALPINE RD | ||||||||
| Address2: | |||||||||
| City: | LOVES PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611113107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159713397 | ||||||||
| FaxNumber: | 8159719795 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2022 | ||||||||
| LastUpdateDate: | 05/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | IL | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.