Mr. Thomas Waller
Mr. Thomas Waller is a Driver in South Holland, Illinois. Licensed in Illinois. Registered with an NPI since 2008.
- Licensed in
- IL
- In the registry since
- 2008
Practice location Address checks out
430 E 162nd St Ste 522South Holland, IL 60473-2258
Phone: (773) 895-3921
Fax: (708) 575-0432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X · Licence W46082583086 (IL) |
|---|
Record details
| NPI number | 1518113067 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 15, 2008 |
| Last updated in NPPES | August 15, 2008 |
| Mailing address | 430 E 162nd St, Suite 522, South Holland, IL 60473-2258 |
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