Individual
THOMPSON DZIDZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
925 W 53RD ST, CHICAGO, IL 60609-6109
(773) 727-7548
Mailing address
925 W 53RD ST, CHICAGO, IL 60609-6109
(773) 727-7548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005067
IL
Other
Enumeration date
07/14/2014
Last updated
01/10/2021
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