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General NPI Number Information
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NPI Number | 1013913557
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Entity Type | Individual
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Provider Name | KATHLEEN M BEWLEY-THOMAS DO
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Gender | Female
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 16650 HARLEM AVE STE 1
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City | TINLEY PARK
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State | IL
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Zip | 60477-1847
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Country | US
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Telephone | 708-444-1512
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Fax | 708-444-1878
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Provider Business Mailing Address
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Address Line | 35318 EAGLE WAY
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City | CHICAGO
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State | IL
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Zip | 60678-1353
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036108151
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License Number State | IL
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