Individual
MS. TAMMARA PETRILL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CADC
Contact information
Practice address
4700 W 95TH ST, SUITE LL5, OAK LAWN, IL 60453-2533
(708) 499-6286
Mailing address
2340 W 111TH ST # 1, CHICAGO, IL 60643-3924
(773) 426-2317
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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