Individual
DR. STEPHEN C THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 119, PEORIA, IL 61614-5098
(309) 692-1700
Mailing address
7104 N BLAIR CT, PEORIA, IL 61614-2100
(309) 691-8212
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036076612
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076612
—
IL
Enumeration date
05/15/2006
Last updated
11/18/2014
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