Individual
DR. THANH SON THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036123833
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123833
—
IL
01
—
IL3952004
MEDICARE PTAN
IL
Enumeration date
08/04/2008
Last updated
02/07/2022
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