Thompson, Michael Gregory
Thompson, Michael Gregory is an sole proprietor health care provider with primary practice located at 4230 Lincolnshire Dr Suite E, Mount Vernon IL 62864-2189. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Thompson, Michael Gregory can be contacted via phone (618) 242-4290.Contact Information
Primary practice address
4230 Lincolnshire Dr Suite E
Mount Vernon IL 62864-2189
Phone: (618) 242-4290
Fax: (618) 242-4209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | Illinois | |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | Illinois |
Profile Details
| NPI number | 1972612901 |
|---|---|
| LBN Legal business name | Thompson, Michael Gregory |
| Credentials | LCPC , CRADC , SAP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972612901 | NPPES |
| Illinois | Other | 04128084 | BLUE CROSS BLUE SHIELD |
| Illinois | Other | 5266705 | BLUE CROSS BLUE SHIELD |
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