MEDICARE: DR. GREGORY ALLEN THOMPSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	036-086468	IL

General Provider Information

NPI Number	:	1114920311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY ALLEN THOMPSON MD

Provider Business Mailing Address
First Line	:	33 W MONROE ST
Second Line	:	SUITE 600
City	:	CHICAGO
State	:	IL
Zip	:	60603-5300
Country	:	US
Telephone Number	:	312-894-5784
Fax Number	:	312-894-5784

Provider Business Practice Location Address
First Line	:	33 W MONROE ST
Second Line	:	SUITE 600
City	:	CHICAGO
State	:	IL
Zip	:	60603-5300
Country	:	US
Telephone Number	:	312-894-5784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/26/2010

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