Healthcare Provider Details

I. General information

NPI: 1265346647
Provider Name (Legal Business Name): JANE S THOMAS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 W 95TH ST STE 308
OAK LAWN IL
60453-2660
US

IV. Provider business mailing address

1901 S MEYERS RD STE 158
OAKBROOK TERRACE IL
60181-5278
US

V. Phone/Fax

Practice location:
  • Phone: 708-346-4040
  • Fax: 708-346-3287
Mailing address:
  • Phone: 708-346-4040
  • Fax: 708-346-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number085.012568
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: