Individual
DR. PRAMERN SRIRATANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1606 HUNT DR, NORMAL, IL 61761-2192
(309) 452-9701
(309) 454-1957
Mailing address
1606 HUNT DR, NORMAL, IL 61761-2192
(309) 452-9701
(309) 454-1957
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036050943
IL
207RH0003X
Hematology & Oncology Physician
Primary
036050943
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050943
—
IL
Enumeration date
07/20/2005
Last updated
02/20/2024
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