Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Antonio Terell Thomas, PMNHP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1558226910

Antonio Terell Thomas, PMNHP is a Nurse Practitioner in Maryville, Illinois. Qualified in 2025, 1 year ago. Practices with Southern Illinois Associates LLC, a 16-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2025

Practice location Address checks out

6805 State Route 162
Maryville, IL 62062-8530
Phone: (618) 288-5019
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209034699 (IL)

Record details

NPI number1558226910
Entity typeIndividual (Type 1)
GenderMale
Credentials PMNHP
Sole proprietorNo
NPI enumeratedDecember 18, 2025
Last updated in NPPESApril 23, 2026
Certification dateApril 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Southern Illinois Associates Llc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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