Individual
DR. PUANGPETH - JANTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6380
(312) 569-8050
Mailing address
4202 YORKSHIRE LN, NORTHBROOK, IL 60062-2917
(847) 480-9069
(312) 569-8050
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
IL
Other
Enumeration date
06/10/2006
Last updated
07/08/2007
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