Individual
KAYLA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-4940
Mailing address
10451 REDWOOD DR, SAINT JOHN, IN 46373-8784
(219) 718-0542
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
036168938
IL
207R00000X
Internal Medicine Physician
Primary
036168938
IL
208000000X
Pediatrics Physician
036168938
IL
208D00000X
General Practice Physician
336.125061
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2021
Last updated
08/05/2024
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