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Contact Information

THOMAS A WIDELL, MD
1501 S CALIFORNIA AVE
CHICAGO, IL60608
 Phone: 773-257-6843
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for THOMAS A WIDELL · (Male)

NPI Number 1932109188
Status Active
Credentials MD
Entity Individual
Enumeration date 07/29/2005
Last updated 08/21/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036084421
  • IL Medicaid 036-084421-2
Hospital affiliation(s)
  • MT SINAI HOSPITAL MEDICAL CENTER - (Acute Care)
    15TH STREET AT CALIFORNIA
    CHICAGO, IL 60608
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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