Provider Demographics
NPI:1447657184
Name:THOMAS, PHILIP EDWARD (RPH)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:EDWARD
Last Name:THOMAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 W ARMY TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-9068
Mailing Address - Country:US
Mailing Address - Phone:630-213-0800
Mailing Address - Fax:630-213-1293
Practice Address - Street 1:942 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-9068
Practice Address - Country:US
Practice Address - Phone:630-213-0800
Practice Address - Fax:630-213-1293
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist