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Individual

DR. THANH SON THAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
137 N OAK PARK AVE STE 209, OAK PARK, IL 60301-1340
(872) 216-2227
(872) 228-8006
Mailing address
137 N OAK PARK AVE STE 209, OAK PARK, IL 60301-1340
(872) 216-2227
(872) 228-8006

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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