Individual
SIR JOHN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 E MASON ST STE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Mailing address
619 E MASON ST STE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041417130
IL
363L00000X
Nurse Practitioner
Primary
209033075
IL
Other
Enumeration date
08/07/2025
Last updated
10/14/2025
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