Provider Demographics
NPI:1063411510
Name:THOMMES, JUDITH ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:PROF
First Name:JUDITH
Middle Name:ANN
Last Name:THOMMES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1555 BARRINGTON RD. SUITE #415
Mailing Address - Street 2:ABMC PEDS SPECIALTY GROUP
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169
Mailing Address - Country:US
Mailing Address - Phone:847-843-2000
Mailing Address - Fax:
Practice Address - Street 1:1555 BARRINGTON RD. SUITE 415
Practice Address - Street 2:ALEXIAN BROS MED GROUP - PEDS SPECIALTY GROUP
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-755-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209005112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK45875Medicare PIN
ILK45876Medicare UPIN