Provider Demographics
NPI:1902389653
Name:THOMAS, SUBIL A (PA-C)
Entity Type:Individual
Prefix:
First Name:SUBIL
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:635 N DEARBORN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4618
Mailing Address - Country:US
Mailing Address - Phone:312-694-2273
Mailing Address - Fax:312-694-2129
Practice Address - Street 1:1435 N RANDALL RD STE 103
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2302
Practice Address - Country:US
Practice Address - Phone:815-398-9491
Practice Address - Fax:815-381-7333
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2022-10-31
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Provider Licenses
StateLicense IDTaxonomies
IL085006804363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant