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Organization
ALLERGY AND ASTHMA ASSOCIATES OF JOLIET, S.C.
Active
Organization
ALLERGY AND ASTHMA ASSOCIATES OF JOLIET, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VORAPHOT SATHISSARAT MD (HEAD OF CORPORATION)
(815) 741-1212
Entity
Organization
Contact information
Practice address
2000 GLENWOOD AVE, SUITE 100, JOLIET, IL 60435-5676
(815) 741-1212
(815) 741-0707
Mailing address
2000 GLENWOOD AVE, SUITE 100, JOLIET, IL 60435-5676
(815) 741-1212
(815) 741-0707
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036046328
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046328
—
IL
01
—
09932417
BCBS
IL
Enumeration date
11/16/2007
Last updated
11/02/2010
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