Individual
ELIZABETH K THORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
9634 S PULASKI RD, OAK LAWN, IL 60453-3391
(708) 423-4800
(708) 423-4843
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015899
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
200852
MEDICARE GROUP #
IL
01
—
202542
MEDICARE GROUP #
IL
01
—
367885100
U S DEPT OF LABOR
IL
01
—
CJ4383
R.R. MEDICARE GROUP #
IL
Enumeration date
11/05/2007
Last updated
12/03/2008
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