Provider Demographics
NPI:1083397863
Name:THOMAS, NEETHU SUSAN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:NEETHU
Middle Name:SUSAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-4757
Practice Address - Street 1:27790 W HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2340
Practice Address - Country:US
Practice Address - Phone:847-620-6077
Practice Address - Fax:847-842-4887
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209027971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily