Individual
KEVIN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2451 N LINCOLN AVE STE 206, CHICAGO, IL 60614-2422
(888) 428-7890
Mailing address
1853 W 37TH ST APT 3, CHICAGO, IL 60609-2019
(779) 475-3371
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.018702
IL
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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