Individual
ASHLEY THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2701
(708) 422-6200
Mailing address
1458 W GRACE ST APT 3, CHICAGO, IL 60613-6885
(614) 732-7454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008878
IL
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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