| Doctor Name: | DR. THOMAS D O'BRYAN |
| NPI Number: | 1205059128 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.C., C.C.N. |
| License Number: | 0038-4472 |
| Business Practice Address: | 28379 Davis Pkwy Suite 801 Warrenville, IL - 605553032 |
| Business Phone Number: | 6303939800 |
| Business Fax Number: | 6303930499 |
| Mailing Address: | 624 Sheridan Sq Apt 3, EVANSTON |
| State: | IL |
| Postal Code: | 602024750 |
| Phone Number: | 8477331710 |
| Fax Number: | 8477331711 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 0038-4472 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |