| Doctor Name: | MR. THOMAS A MAIBENCO |
| NPI Number: | 1639211386 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 916 Talon Drive Suite 102 Ofallon, IL - 622691848 |
| Business Phone Number: | 6186288211 |
| Business Fax Number: | 6186280883 |
| Mailing Address: | 916 Talon Drive, Suite 102 OFALLON |
| State: | IL |
| Postal Code: | 622691848 |
| Phone Number: | 6186288211 |
| Fax Number: | 6186280883 |
| NPI Enumeration Date: | 02/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2081P2900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Physical Medicine & Rehabilitation |
| Taxonomy Specialization: | Pain Medicine |
| Taxonomy Definition: | A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |