Individual
TREVONNE M. THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
808 S WOOD ST, MC724, CHICAGO, IL 60612-7300
(312) 355-0445
Mailing address
808 S WOOD ST, MC724, CHICAGO, IL 60612-7300
(312) 355-0445
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036112845
IL
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
036-112845
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112845
—
IL
Enumeration date
08/11/2005
Last updated
09/25/2011
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