Individual
JOSEPH MATTHEW THIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
558 WEST DE KOVEN, CHICAGO, IL 60607
(773) 706-1632
Mailing address
558 WEST DE KOVEN, CHICAGO, IL 60607
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
060352333
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000
—
IL
Enumeration date
09/19/2019
Last updated
09/19/2019
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