| Doctor Name: | DR. THOMAS L. MICHALSEN |
| NPI Number: | 1114947876 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 036066772 |
| Business Practice Address: | 406 South 5th Street Kirkland, IL - 60146 |
| Business Phone Number: | 8155223301 |
| Business Fax Number: | 8155223855 |
| Mailing Address: | 1713 Oakwood Glen Close, ROCKFORD |
| State: | IL |
| Postal Code: | 611087011 |
| Phone Number: | 8153324660 |
| Fax Number: | |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 07/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036066772 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |