Individual
ATHITTAYA TECHAWANTOCHANDEJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4646 N MARINE DR FL 7, CHICAGO, IL 60640-5759
(773) 564-5225
Mailing address
4646 N MARINE DR FL 7, CHICAGO, IL 60640-5759
(773) 564-5225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125073503
IL
Other
Enumeration date
06/11/2019
Last updated
06/12/2019
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