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Individual

DR. SHAWN THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
30 N MICHIGAN AVE STE 1904, CHICAGO, IL 60602
(312) 236-8514
(312) 372-1743
Mailing address
30 N MICHIGAN AVE STE 1904, CHICAGO, IL 60602-3605
(312) 236-8514
(312) 372-1743

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DS040876
PA
1223P0300X
Periodontics
Primary
021002952
IL

Other

Enumeration date
06/09/2016
Last updated
11/15/2019
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