Individual
TANYARAT SUWANNETR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 947-8800
Mailing address
4730 N TROY ST, CHICAGO, IL 60625-4423
(773) 576-4231
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
209.033384
IL
Other
Enumeration date
04/29/2025
Last updated
09/25/2025
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