Provider Demographics
NPI:1730146671
Name:PITTS, THOMAS L (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:L
Last Name:PITTS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:233 E ERIE ST
Mailing Address - Street 2:SUITE 702
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2926
Mailing Address - Country:US
Mailing Address - Phone:312-763-2211
Mailing Address - Fax:312-763-2210
Practice Address - Street 1:201 E HURON ST
Practice Address - Street 2:SUITE 12-160
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3197
Practice Address - Country:US
Practice Address - Phone:312-695-1700
Practice Address - Fax:312-695-1777
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2021-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-03656168207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036056168Medicaid
ILD13733Medicare UPIN
IL670920Medicare PIN