Organization Active NPI

Thomas a. Wroblewski, M.D., S.C.

  • Internal Medicine Physician
  • Kankakee, IL
National Provider Identifier
1538428586
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036067296 Issued in IL
Legal business name
THOMAS A. WROBLEWSKI, M.D., S.C.
Practice address
401 N Wall St
Ste. 102
Kankakee, IL 60901-2934
Phone
(815) 937-4404
Fax
(815) 937-4516
NPI assigned
May 11, 2012
Last updated
May 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Dr. Thomas A. Wroblewski, M.D.
Title
President
Phone
(815) 937-4404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036067296 IL Primary

Addresses

Primary practice location

401 N Wall St
Ste. 102
Kankakee, IL 60901-2934

Mailing address

401 N Wall St
Ste. 102
Kankakee, IL 60901-2934
Phone (815) 937-4404

National Provider Directory

National Provider Directory

Locations

401 N Wall St
Ste 102
Kankakee, IL 60901
Phone (815) 928-5090

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1538428586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N WALL ST",
            "address_2": "STE. 102",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012934",
            "telephone_number": "815-937-4404",
            "fax_number": "815-937-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N WALL ST",
            "address_2": "STE. 102",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012934",
            "telephone_number": "815-937-4404",
            "fax_number": "815-937-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS A. WROBLEWSKI, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "WROBLEWSKI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-937-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036067296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.