Individual
DR. CHERDKIAT SANGKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1205 S MAIN ST STE 201, CROWN POINT, IN 46307-3677
(219) 769-8340
(219) 769-8341
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01035696A
IN
207RC0000X
Cardiovascular Disease Physician
036056561
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056561
—
IL
01
—
1124399605
BCBS GROUP NUMBER
IL
05
—
201283530
—
IN
Enumeration date
11/15/2005
Last updated
05/03/2026
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