Basic Information
| Provider Information | |||||||||
| NPI: | 1518905819 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DISCHER | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1919 S HIGHLAND AVE | ||||||||
| Address2: | SUITE B202 ATTN JAN LEWIS | ||||||||
| City: | LOMBARD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601486153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302681102 | ||||||||
| FaxNumber: | 6302681125 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 N WINFIELD RD | ||||||||
| Address2: | NORTH ENTRANCE | ||||||||
| City: | WINFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305109244 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 12/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 036084817 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 060070203 | 01 | RAILROAD MEDICARE | OTHER | 036084817 | 05 | IL | MEDICAID |