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1962270207
TAJA LANIECE THOMPSON
CHICAGO, IL
NPI
1962270207
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085010238)
Enumeration Date
2023-12-15
Last Update Date
2024-02-29
Business Address
TAJA LANIECE THOMPSON PA-C
1276 N CLYBOURN AVE
CHICAGO, IL 60610-2003
Phone number: 312-337-1073
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Mailing Address
TAJA LANIECE THOMPSON PA-C
1276 N CLYBOURN AVE
CHICAGO, IL 60610-2089
Phone number:
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