Healthcare Provider Details

I. General information

NPI: 1366201162
Provider Name (Legal Business Name): CLAIRE THOMPSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 PFINGSTEN RD. SUITE 360
GLENVIEW IL
60026-1313
US

IV. Provider business mailing address

2650 RIDGE AVE. SUITE 1223
EVANSTON IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 847-998-4170
  • Fax: 847-998-4165
Mailing address:
  • Phone: 847-570-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.008612RX
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085010418
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: