Individual
ETHAN UNGCHUSRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637
(773) 702-3550
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036171306
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2018
Last updated
09/05/2024
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