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NPI Code Detail

MEDICARE: JENNIFER L THOMAS M.D.

MEDICARE:   JENNIFER L THOMAS  M.D.
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
1207Q00000XFamily Medicine Physician036124327IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811181712
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L THOMAS M.D.
Provider Business Mailing Address
First Line : 201 S WABENA AVE
Second Line : SUITE 2B
City : MINOOKA
State : IL
Zip : 60447-8715
Country : US
Telephone Number : 815-941-9124
Fax Number : 815-941-9128
Provider Business Practice Location Address
First Line : 389 E MAIN ST
Second Line :
City : BRAIDWOOD
State : IL
Zip : 60408-2010
Country : US
Telephone Number : 815-458-2532
Fax Number : 815-458-2455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2007
Last Update Date : 05/16/2017

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Directions to “ JENNIFER L THOMAS M.D.” Practice Location

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