Individual
GRACE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
422 N NORTHWEST HWY STE 210, PARK RIDGE, IL 60068-3273
(847) 699-9757
Mailing address
1900 N LINCOLN AVE UNIT 102, CHICAGO, IL 60614-6573
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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