Individual
DR. PANTILA VANICHAKARN BATEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 SURRYSE RD STE 100, LAKE ZURICH, IL 60047-3217
(815) 206-5700
(847) 382-1771
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-4959
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
226001
MA
207RC0000X
Cardiovascular Disease Physician
01075398A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036161785
IL
207RC0000X
Cardiovascular Disease Physician
15273
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201313450
—
IN
Enumeration date
04/24/2008
Last updated
09/09/2024
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