Provider Demographics
NPI:1508954926
Name:THOMPSON, VALERIE S (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:S
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2901 OLD JACKSONVILLE RD
Mailing Address - Street 2:SUITE B4
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7437
Mailing Address - Country:US
Mailing Address - Phone:217-241-3586
Mailing Address - Fax:217-241-3589
Practice Address - Street 1:2901 OLD JACKSONVILLE RD
Practice Address - Street 2:SUITE B4
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7437
Practice Address - Country:US
Practice Address - Phone:217-241-3586
Practice Address - Fax:217-241-3589
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-12-27
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Provider Licenses
StateLicense IDTaxonomies
IL036-115383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine