Provider Demographics
NPI:1073739611
Name:MICHELE P THATCHER MD LTD
Entity Type:Organization
Organization Name:MICHELE P THATCHER MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLONNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-377-6185
Mailing Address - Street 1:2320 DEAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-1068
Mailing Address - Country:US
Mailing Address - Phone:630-377-4048
Mailing Address - Fax:630-377-8305
Practice Address - Street 1:2320 DEAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1068
Practice Address - Country:US
Practice Address - Phone:630-377-4048
Practice Address - Fax:630-377-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty