Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 070007208 | IL |
NPI | 1033303078 |
---|---|
Provider Name | Sharon V. Thompson |
First Address | Naperville, IL 60565-2867 |
Second Address | Aurora, IL 60504-7925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 04/10/2013 |