Individual
GARY D THAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ASTELLAS WAY, NORTHBROOK, IL 60062-6111
(224) 205-5278
Mailing address
1 ASTELLAS WAY, NORTHBROOK, IL 60062-6111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
77798
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
77798
MA
Other
Enumeration date
06/14/2006
Last updated
03/27/2014
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