=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992559827
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOY THOMAS CD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2024
-----------------------------------------------------
Last Update Date | 04/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3 SAUK CT
-----------------------------------------------------
City | PARK FOREST
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60466-2024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-280-0142
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 SAUK CT
-----------------------------------------------------
City | PARK FOREST
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60466-2024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-280-0142
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------