Organization
ADVANCED NATURAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SITIHIAMPHONE PHETCHAMPHONE D.C. LAC. (D.C)
(630) 833-3799
Entity
Organization
Contact information
Practice address
17W300 22ND ST, SUITE 460, OAKBROOK TERRACE, IL 60181-4405
(630) 833-3799
(630) 833-3830
Mailing address
17W300 22ND ST, SUITE 460, OAKBROOK TERRACE, IL 60181-4405
(630) 833-3799
(630) 833-3830
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
038009954
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232336
BCBS-IL
IL
Enumeration date
04/29/2008
Last updated
08/27/2008
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