Individual
JAYA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3915 OGLESBY AVE, GURNEE, IL 60031-3358
(847) 336-1600
(847) 336-2380
Mailing address
3915 OGLESBY AVE, GURNEE, IL 60031-3358
(847) 336-1600
(847) 336-2380
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036070603
IL
208000000X
Pediatrics Physician
Primary
036070603
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070603
—
IL
Enumeration date
05/04/2006
Last updated
01/11/2012
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