SURASAK PRATUANGTHAM MD NPI 1639164601

NPI Information

NPI: 1639164601
Provider Name: SURASAK PRATUANGTHAM, MD
Classification: Pediatrics - 2080P0208X
Entity Type: Individual

Specialization: Pediatric Infectious Diseases

Address:
4440 W 95TH ST
OAK LAWN, IL
ZIP 60453
Phone: (708) 727-1267
Get Directions

Surasak Pratuangtham, MD is a pediatric infectious diseases pediatrics in Oak Lawn, IL. The provider is a pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. Surasak Pratuangtham, MD NPI is 1639164601. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4440 W 95TH ST
OAK LAWN, IL
ZIP 60453-600
Phone: (708) 727-1267

The enumeration date for this NPI number is 9/15/2005 and was last updated on 12/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0208X	Pediatrics	Pediatric Infectious Diseases	036085443	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	25601	OTHER	ILLINOIS	ADVOCATE HLTH PARTNERS ID
2	036085443	MEDICAID	ILLINOIS
3	01626483	OTHER	ILLINOIS	BCBS PROVIDER ID
4	200331500A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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