Individual
DR. HARRY REED THOMPSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
413 E UNIVERSITY AVE, CHAMPAIGN, IL 61820-3826
(217) 359-9601
(217) 359-9609
Mailing address
413 E UNIVERSITY AVE, CHAMPAIGN, IL 61820-3826
(217) 359-9601
(217) 359-9609
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036065943
IL
208D00000X
General Practice Physician
036065943
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001000344
BLUE SHIELD OF IL
IL
01
—
020032301
RAILROAD MEDICARE
IL
05
—
036065943
—
IL
01
—
3567913001
CIGNA INSURANCE
IL
01
—
371189625
TAX ID MISC INSURANCES
IL
Enumeration date
02/05/2007
Last updated
11/17/2010
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