Organization
EVERGREEN CARE CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE THOMAS MD (OWNER)
(708) 423-6209
Entity
Organization
Contact information
Practice address
9760 S KEDZIE AVE, SUITE 3, EVERGREEN PARK, IL 60805-3109
(708) 423-6209
(708) 423-9021
Mailing address
9760 S KEDZIE AVE, SUITE 3, EVERGREEN PARK, IL 60805-3109
(708) 423-6209
(708) 423-9021
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036084895
—
IL
01
—
DA0131
RAIL ROAD MEDICARE
IL
Enumeration date
10/23/2007
Last updated
04/29/2025
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