Provider Demographics
NPI:1821539347
Name:THOMANN, CATHARINE ROSE BEDA (PHD)
Entity Type:Individual
Prefix:
First Name:CATHARINE
Middle Name:ROSE BEDA
Last Name:THOMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 S WABASH AVE
Mailing Address - Street 2:#3E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2846
Mailing Address - Country:US
Mailing Address - Phone:541-554-9769
Mailing Address - Fax:
Practice Address - Street 1:1111 E 87TH ST
Practice Address - Street 2:SUITE 800
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-7038
Practice Address - Country:US
Practice Address - Phone:773-374-3748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical