Individual
MR. CHAIYAPON COUROPMITREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3416 HARLEM AVE, RIVERSIDE, IL 60546-2604
(708) 442-6161
(708) 442-7188
Mailing address
3416 HARLEM AVE, RIVERSIDE, IL 60546-2604
(708) 442-6161
(708) 442-7188
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036-045186
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-045186
STATE LICENSE NUMBER
IL
Enumeration date
08/31/2006
Last updated
07/08/2007
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