Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036062633 | IL |
N | 111NI0900X | Internist | 036062633 | IL |
Y | 207RH0002X | Hospice and Palliative Medicine | 036-062633 | IL |
NPI | 1235141359 |
---|---|
Provider Name | Michael F Thomas |
First Address | Chicago, IL 60612-3723 |
Second Address | Evergreen Park, IL 60805-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 30/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036062633 | (05) | IL |
C43674 | (02) | IL |