Individual
MRS. LERETHA RENELL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3912 W 76TH PL, CHICAGO, IL 60652-1316
(773) 884-0107
(773) 884-0553
Mailing address
3912 WEST 76TH PLACE, CHICAGO, IL 60652-1316
(773) 884-0107
(773) 884-0553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041219317
IL
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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