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General NPI Number Information
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NPI Number | 1427090125
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Entity Type | Organization
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Legal Business Name | THOMAS AND THOMAS MEDICAL LTD
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 222 S GREENLEAF ST STE 109
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City | GURNEE
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State | IL
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Zip | 60031-5705
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Country | US
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Telephone | 847-336-1600
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Fax | 847-336-2380
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Provider Business Mailing Address
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Address Line | 222 S GREENLEAF ST STE 109
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City | GURNEE
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State | IL
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Zip | 60031-5705
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Country | US
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Telephone | 847-336-1600
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Fax | 847-336-2380
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Authorized Official
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Title or Position | CREDENTIALING/BILLING SPECIALIST
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Name | SHERLENE MAY GIRON DASALLA
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Credential |
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Telephone | 847-336-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036109155
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License Number State | IL
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