Mark Tomera MC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036065652 Issued in IL

Legal business name

MARK TOMERA MC

Practice address

7579 Lake St
River Forest, IL 60305-1846

Phone

(708) 366-7177

NPI assigned

Jun 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth Brundgae

Title

Director of Operations

Phone

(708) 366-7177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Tomera, MD

  • Surgery Physician
  • River Forest, IL
  • NPI 1043311665
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1386805570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7579 LAKE ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051846",
            "telephone_number": "708-366-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7579 LAKE ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051846",
            "telephone_number": "708-366-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TOMERA MC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "BRUNDGAE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "708-366-7177"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": "036065652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065652",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Lynch
• Sheila E Lynch
• Jordan Lynn, ATC
• Bernardo Mangilin
• Mantilla Surgical SC
• Markovic Medical Inc
• Gary Marshall Mart, M.D.
• Barbara Martin, MA CCC-SLP
• Mary L. Kelly, D.O., S.C.
• George Robert Mason, M.D.

• Surgery Physician in River Forest, IL
• Providers in River Forest, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.