# THAD TREJO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1255870796
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2100X | Acute Care Nurse Practitioner | 206.015167 | IL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | 209015167 | IL | — |
| 363LG0600X | Gerontology Nurse Practitioner | 209015167 | IL | — |

## Other

- **Enumeration date:** 02/16/2017
- **Last updated:** 08/03/2026