Individual
MS. PRATHIBHA THACHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
Mailing address
6965 W NILES TER, NILES, IL 60714-4350
(847) 983-4902
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.007240
IL
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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