Individual
DR. PENELOPE ANN THRASHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
66 W OAK ST, CHICAGO, IL 60610-7325
(312) 337-5400
Mailing address
8926B LA CROSSE AVE, SKOKIE, IL 60077-1940
(847) 674-9313
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001632038
BLUE CROSS BLUE SHIELD
IL
01
—
480277
VALUE OPTIONS
IL
Enumeration date
04/02/2007
Last updated
07/09/2007
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