Healthcare Provider Details

I. General information

NPI: 1356274286
Provider Name (Legal Business Name): MICHELLE THOMMI DO, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 W WINONA ST
CHICAGO IL
60625-2508
US

IV. Provider business mailing address

2751 W WINONA ST
CHICAGO IL
60625-2508
US

V. Phone/Fax

Practice location:
  • Phone: 773-989-6202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125087877
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: