Individual
BONNIE WILLIAM THOMAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1525 E 55TH ST, CHICAGO, IL 60615-5512
(773) 548-3957
(773) 753-5590
Mailing address
1525 E 55TH ST, CHICAGO, IL 60615-5512
(773) 548-3957
(773) 753-5590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036101029
IL
207R00000X
Internal Medicine Physician
036102029
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102029
—
IL
Enumeration date
07/03/2006
Last updated
01/06/2022
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