Healthcare Provider Details

I. General information

NPI: 1225942709
Provider Name (Legal Business Name): JOYSON THOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8281 W OAK AVE
NILES IL
60714-1625
US

IV. Provider business mailing address

8281 W OAK AVE
NILES IL
60714-1625
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-1336
  • Fax:
Mailing address:
  • Phone: 708-202-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number041.460274
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: