Provider Demographics
NPI:1053380642
Name:DIGIULIO, THOMAS ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:DIGIULIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27790 W HIGHWAY 22
Mailing Address - Street 2:STE 32
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2396
Mailing Address - Country:US
Mailing Address - Phone:847-304-4041
Mailing Address - Fax:847-381-0604
Practice Address - Street 1:27790 W HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2396
Practice Address - Country:US
Practice Address - Phone:847-381-8181
Practice Address - Fax:847-381-0604
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36072132207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04915108OtherBLUE CROSS/BLUE SHIELD
IL036072132Medicaid
ILL66062Medicare ID - Type UnspecifiedMEDICARE ID
ILF84905Medicare UPIN