Individual
MICHAEL SCOTT THOMAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10640 165TH ST, ORLAND PARK, IL 60467-8734
(708) 364-0261
Mailing address
10640 165TH ST, ORLAND PARK, IL 60467-8734
(708) 364-0261
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009104
IL
Other
Enumeration date
07/25/2022
Last updated
08/02/2023
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