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General NPI Number Information
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NPI Number | 1497318372
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Entity Type | Individual
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Provider Name | RACHAEL ELIZABETH THOMAS BSN, APN
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Gender | Female
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 333 S DESPLAINES ST STE 201
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City | CHICAGO
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State | IL
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Zip | 60661-5514
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Country | US
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Telephone | 866-258-8467
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Fax |
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Provider Business Mailing Address
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Address Line | 420 W BELMONT AVE APT 21C
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City | CHICAGO
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State | IL
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Zip | 60657-4731
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Country | US
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Telephone | 512-663-0381
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 209.019214
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License Number State | IL
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