Provider Demographics
NPI:1619238086
Name:THOMAS, TENY PHILIP (MD)
Entity Type:Individual
Prefix:MRS
First Name:TENY
Middle Name:PHILIP
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:TENY
Other - Middle Name:ANNA
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9977 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1057
Mailing Address - Country:US
Mailing Address - Phone:847-663-8250
Mailing Address - Fax:847-663-8242
Practice Address - Street 1:1885 SHERMER RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5317
Practice Address - Country:US
Practice Address - Phone:847-272-4600
Practice Address - Fax:847-272-4655
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036139661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program