Thibault Bordeau

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Mundelein, IL

NPI 1629829338 · NPPES record last updated Mar 29, 2024

Key facts

NPI
1629829338
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1640 Savannah Cir
Mundelein, IL 60060-1637
Phone
(847) 507-4758
NPI assigned
Mar 29, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1640 Savannah Cir
Mundelein, IL 60060-1637

Mailing address

1640 Savannah Cir
Mundelein, IL 60060-1637
Phone (847) 507-4758

Other providers in Mundelein, IL

All providers in Mundelein, IL · Student in an Organized Health Care Education/Training Program in Illinois

Sources for this page

Verify at the official NPI Registry.