Healthcare Provider Details

I. General information

NPI: 1225992001
Provider Name (Legal Business Name): MS. ANDREA THIGPEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 S EAST END AVE
CHICAGO IL
60617-2807
US

IV. Provider business mailing address

8930 S EAST END AVE
CHICAGO IL
60617-2807
US

V. Phone/Fax

Practice location:
  • Phone: 773-240-5222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: