Healthcare Provider Details

I. General information

NPI: 1720117823
Provider Name (Legal Business Name): ASSOCIATED ALLERGISTS AND ASTHMA SPECIALISTS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10733 W. 165TH ST.
ORLAND PARK IL
60467-8713
US

IV. Provider business mailing address

10733 W. 165TH ST.
ORLAND PARK IL
60467-8713
US

V. Phone/Fax

Practice location:
  • Phone: 708-957-7468
  • Fax: 708-957-7471
Mailing address:
  • Phone: 708-957-7468
  • Fax: 708-957-7471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JAMES ANDERSON THOMPSON
Title or Position: SECRETARY
Credential: MD
Phone: 708-798-2950