Individual
JERRY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 ENGLE ST, DOLTON, IL 60419-1719
(773) 783-3767
Mailing address
630 ENGLE ST, DOLTON, IL 60419-1719
(773) 783-3767
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274659333001
—
IL
Enumeration date
11/18/2025
Last updated
11/18/2025
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