| Thomas L. Michalsen Do Ltd | |
|
406 South 5th Street Kirkland IL 60146 | |
| (815) 522-3301 | |
| (815) 522-3855 |
| Full Name | Thomas L. Michalsen Do Ltd |
|---|---|
| Speciality | General Practice |
| Location | 406 South 5th Street, Kirkland, Illinois |
| Authorized Official Name and Position | Thomas L Michalsen (PRESIDENT) |
| Authorized Official Contact | 8155223301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas L. Michalsen Do Ltd 406 South 5th Street Kirkland IL 60146 Ph: (815) 522-3301 | Thomas L. Michalsen Do Ltd 406 South 5th Street Kirkland IL 60146 Ph: (815) 522-3301 |
| NPI Number | 1841214368 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 08/22/2022 |
| Medicare PECOS PAC ID | 3274609672 |
|---|---|
| Medicare Enrollment ID | O20080909000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841214368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036096167 (Illinois) | Secondary |
| 208D00000X | General Practice | 036066772 (Illinois) | Primary |
| Provider Name | Thomas Michalsen |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114947876 PECOS PAC ID: 9739156043 Enrollment ID: I20080718000036 |
| Provider Name | Cathy L Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225431653 PECOS PAC ID: 4880983378 Enrollment ID: I20221013003459 |