Individual
SURASAK PRATUANGTHAM
Active
Individual
SURASAK PRATUANGTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
036085443
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01626483
BCBS PROVIDER ID
IL
05
—
036085443
—
IL
05
—
200331500A
—
IN
01
—
25601
ADVOCATE HLTH PARTNERS ID
IL
Enumeration date
09/15/2005
Last updated
12/22/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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