Provider Demographics
NPI:1790855740
Name:THOMPSON, PETER A (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29368
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-0368
Mailing Address - Country:US
Mailing Address - Phone:773-585-5900
Mailing Address - Fax:773-585-5980
Practice Address - Street 1:47 W NEW YORK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4120
Practice Address - Country:US
Practice Address - Phone:630-892-7600
Practice Address - Fax:630-893-7694
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27547111N00000X
AZ7549111N00000X
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor