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General NPI Number Information
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NPI Number | 1891213963
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Entity Type | Individual
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Provider Name | JANET M THOMPSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 10/10/2017
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Provider Practice Location Address
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Address Line | 1 INGALLS DR
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City | HARVEY
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State | IL
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Zip | 60426-3558
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Country | US
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Telephone | 708-915-5290
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Fax |
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Provider Business Mailing Address
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Address Line | 15548 LONG AVE
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City | OAK FOREST
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State | IL
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Zip | 60452-3317
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Country | US
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Telephone | 708-362-2390
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-016498
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License Number State | IL
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