Individual
TARATIP THUPVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2000 OGDEN AVE, AURORA, IL 60504-7222
(630) 978-6200
Mailing address
426 SCARBOROUGH RD, VALPARAISO, IN 46385-7718
(219) 462-2594
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036121440
IL
Other
Enumeration date
09/09/2008
Last updated
01/30/2023
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