Provider Demographics
NPI:1104089986
Name:THOMPSON, JANNAH HILARY (MD)
Entity type:Individual
Prefix:DR
First Name:JANNAH
Middle Name:HILARY
Last Name:THOMPSON
Suffix:
Gender:
Credentials:MD
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 776982
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6982
Mailing Address - Country:US
Mailing Address - Phone:231-672-2119
Mailing Address - Fax:
Practice Address - Street 1:6401 PRAIRIE ST STE 1700
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-7843
Practice Address - Country:US
Practice Address - Phone:231-672-7944
Practice Address - Fax:231-672-7994
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095660208800000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No208800000XAllopathic & Osteopathic PhysiciansUrology