Search › Illinois › 332B00000X
Tommy Bohannan
NPI 1407213796 · on the registry since 2016 · sole proprietor
Practice
- Address
- 11417 N Boulder Creek Ct
Dunlap, IL 61525 - Phone
- (309) 678-8081
- Organisation at this address
- Bohannan Medical Dist., Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 332B00000X
332B00000X
- Sex
- Male
- Record last updated
- 2016-03-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois