Thomas Erdey
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Loda, IL
NPI 1811523632 · NPPES record last updated Mar 13, 2020
Key facts
- NPI
- 1811523632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 138 Sunrise CT
Loda, IL 60948-9749 - Phone
- (779) 435-3916
- NPI assigned
- Mar 13, 2020
- Sex
- Male
- Sole proprietor
- No
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
138 Sunrise CT
Loda, IL 60948-9749
Mailing address
138 Sunrise CT
Loda, IL 60948-9749
Phone (779) 435-3916
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69 | Medicaid | DC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/a |
Other providers in Loda, IL
All providers in Loda, IL · Student in an Organized Health Care Education/Training Program in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.