Individual
MR. JEFFREY ALLEN THOMAS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS,ATC/L
Contact information
Practice address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
Mailing address
633 W DEMING PL, CHICAGO, IL 60614-2658
(312) 485-4899
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
96001787
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96001787
IL STATE LIC. NUMBER
IL
Enumeration date
11/29/2005
Last updated
07/08/2007
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