Individual
MELLISA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 WATSEKA ST, PARK FOREST, IL 60466-1307
(773) 550-8356
Mailing address
413 WATSEKA ST, PARK FOREST, IL 60466-1307
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041574707
IL
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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