Individual
ALLEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1801 WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-8130
(217) 366-6106
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-8107
(217) 366-6106
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-000889
IL
Other
Enumeration date
07/17/2006
Last updated
03/05/2015
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