MEDICARE: DR. SONYA L THOMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	036093278	IL

General Provider Information

NPI Number	:	1780698712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONYA L THOMAS MD

Provider Business Mailing Address
First Line	:	P.O. BOX 09091
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-9998
Country	:	US
Telephone Number	:	773-277-2227
Fax Number	:	773-522-5613

Provider Business Practice Location Address
First Line	:	4230 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4316
Country	:	US
Telephone Number	:	773-277-2227
Fax Number	:	773-522-5613

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	12/01/2010

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