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Individual

DANA MARA THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
225 E CHICAGO AVE # 25, ANN AND ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL 60611-2991
(312) 227-4000
(312) 225-9414
Mailing address
225 E CHICAGO AVE # 25, ANN AND ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL 60611-2991
(312) 227-4000
(312) 225-9414

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
036.131871
IL
207YP0228X
Pediatric Otolaryngology Physician
Primary
036.131871
IL
207YP0228X
Pediatric Otolaryngology Physician
35.072848
OH
207YP0228X
Pediatric Otolaryngology Physician
35521
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040013679
MEDICARE RAILROAD
MN
05
389020100
MN
Enumeration date
01/11/2006
Last updated
04/30/2013
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