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General NPI Number Information
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NPI Number | 1528025046
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Entity Type | Individual
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Provider Name | CECELIA YVETTE THURMAN PA
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Gender | Female
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 565 LAKEVIEW PKWY 116
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City | VERNON HILLS
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State | IL
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Zip | 60061-1857
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Country | US
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Telephone | 847-367-7340
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Fax | 847-247-2840
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Provider Business Mailing Address
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Address Line | 565 LAKEVIEW PKWY SUITE 116
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City | VERNON HILLS
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State | IL
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Zip | 60061-1857
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Country | US
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Telephone | 847-367-7340
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Fax | 847-247-2840
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085001035
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License Number State | IL
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