Individual
MANJU THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3926 N NEWLAND AVE, CHICAGO, IL 60634-2315
(773) 736-0851
Mailing address
1900 W HARRISON ST, CHICAGO, IL 60612-3736
(773) 736-0851
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.010969
IL
Other
Enumeration date
04/23/2014
Last updated
04/30/2021
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