Individual
THASARAT S VAJARANANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1855 W TAYLOR ST, CHICAGO, IL 60612-7242
(312) 996-7030
(312) 996-7770
Mailing address
1855 W TAYLOR STREET, 2.21 EEI, MC 648, CHICAGO, IL 60612
(312) 996-7030
(312) 996-7770
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036115587
IL
Other
Enumeration date
07/25/2006
Last updated
05/03/2018
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