Individual
JENNIFER L THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
389 E MAIN ST, BRAIDWOOD, IL 60408-2010
(815) 458-2532
(815) 458-2455
Mailing address
201 S WABENA AVE, SUITE 2B, MINOOKA, IL 60447-8715
(815) 941-9124
(815) 941-9128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036124327
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124327
—
IL
Enumeration date
09/04/2007
Last updated
05/16/2017
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