Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Thomas Waller

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1780116376

Thomas Waller is an Infectious Disease in Chicago, Illinois. Graduated from Midwestern University College of Dental Medicine, Downers Grove in 2017, 9 years ago. Practices with Cook County, a 787-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
9
Trained at
Midwestern University College of Dental Medicine, Downers Grove
Licensed in
IL
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1620 W Harrison St
Chicago, IL 60612-3801
Phone: (312) 942-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 20201 Crawford Ave, Olympia Fields, IL 60461-1010 — (708) 747-4000

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence 036.153369 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1780116376
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 1, 2017
Last updated in NPPESJuly 16, 2020
Certification dateJuly 16, 2020
Mailing address5321 N Moody Ave, Chicago, IL 60630-1048

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINFECTIOUS DISEASE
Medical schoolMIDWESTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE, DOWNERS GROVE
Graduated 2017 (9 years in practice)
Group practice Cook County — 787 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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