Individual
JIBIE THOMAS JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-4482
Mailing address
316 WESTMORELAND DR, VERNON HILLS, IL 60061-2717
(224) 505-3001
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.135551
IL
164W00000X
Licensed Practical Nurse
331598
WI
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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