Individual
PANOM PHOUNGCHERDCHOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8311 ROOSEVELT RD, FOREST PARK, IL 60130-2529
(708) 771-7000
Mailing address
1745 PAVILION WAY, UNIT 207, PARK RIDGE, IL 60068-1163
(847) 698-3470
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036045322
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045322
—
IL
Enumeration date
05/20/2006
Last updated
05/22/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us