Healthcare Provider Details

I. General information

NPI: 1225949993
Provider Name (Legal Business Name): NATSHUN A THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E 103RD ST APT 1
CHICAGO IL
60628-2807
US

IV. Provider business mailing address

5250 W BLOOMINGDALE AVE APT 1
CHICAGO IL
60639-4349
US

V. Phone/Fax

Practice location:
  • Phone: 312-371-3600
  • Fax:
Mailing address:
  • Phone: 312-371-3600
  • Fax: 312-581-0418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150108261
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: