Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 036152053 | IL |
NPI | 1013362888 |
---|---|
Provider Name | Catherine Jane Thomas |
First Address | Chicago, IL 60611-3111 |
Second Address | Chicago, IL 60611-3111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2016 |
Last Update Date | 07/08/2020 |