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Individual

DR. REGINALD THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
17800 KEDZIE AVE, EMERGENCY DEPARTMENT, HAZEL CREST, IL 60429-2029
(773) 363-1090
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-112157
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03611215702
IL
01
P00239140
RAILROAD MEDICARE
IL
Enumeration date
01/23/2006
Last updated
09/28/2022
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