# BHIROM BURANAKUL MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649402702
- **Authorized official:** DR. BHIROM BURANAKUL MD (OWNER)
- **Authorized official phone:** (217) 442-5863

## Contact information

- **Practice address:** 102 N LOGAN AVE, DANVILLE, IL 61832-8513
- **Practice address phone:** (217) 442-5863
- **Mailing address:** 102 N LOGAN AVE, DANVILLE, IL 61832-8513
- **Mailing address phone:** (217) 442-5863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2009
- **Last updated:** 08/21/2009