Individual
ALEXIS S THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 OTTO BLVD, CHICAGO HEIGHTS, IL 60411-3871
(708) 733-7200
(708) 733-7222
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-1353
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209010749
IL
363LF0000X
Family Nurse Practitioner
Primary
277000210
IL
363LG0600X
Gerontology Nurse Practitioner
209010749
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400332066
MEDICARE PTN
IL
Enumeration date
10/02/2013
Last updated
03/16/2023
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