Provider Demographics
NPI:1053514646
Name:DEKOJ, THOMAS ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:DEKOJ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1750 E LAKE SHORE DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-3806
Mailing Address - Country:US
Mailing Address - Phone:217-428-6300
Mailing Address - Fax:217-428-6322
Practice Address - Street 1:1750 E LAKE SHORE DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-3806
Practice Address - Country:US
Practice Address - Phone:217-428-6300
Practice Address - Fax:217-428-6322
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2012-08-30
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Provider Licenses
StateLicense IDTaxonomies
NY261007208C00000X
IL036126490208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery