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Individual

TYWAN THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1329 COLDSPRING RD, CAROL STREAM, IL 60188-4713
(773) 818-4135
Mailing address
1329 COLDSPRING RD, CAROL STREAM, IL 60188-4713
(773) 818-4135

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T51281676019
IL

Other

Enumeration date
01/27/2020
Last updated
01/27/2020
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