Provider Demographics
NPI:1013930130
Name:LELIO, THOMAS F (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:LELIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N HAMMES AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6680
Mailing Address - Country:US
Mailing Address - Phone:815-725-6511
Mailing Address - Fax:
Practice Address - Street 1:210 N HAMMES AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6680
Practice Address - Country:US
Practice Address - Phone:815-725-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360797912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL145247Medicare PIN
IL145311Medicare PIN
IL211727Medicare PIN
IL145221Medicare PIN
IL145694Medicare PIN
IL260040422Medicare PIN
IL146061Medicare PIN
IL140213Medicare PIN
IL145029Medicare PIN
IL145892Medicare PIN
IL145372Medicare PIN
IL145618Medicare PIN
ILK45301Medicare PIN
IL145754Medicare PIN
IL145761Medicare PIN
IL145710Medicare PIN