Organization
ALLERGY AND ASTHMA ASSOCIATES OF JOLIET, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VORAPHOT SATHISSARAT MD (HEAD OF CORPORATION)
(815) 741-1212
Entity
Organization
Contact information
Practice address
2000 GLENWOOD AVE, SUITE 100, JOLIET, IL 60435-5676
(815) 741-1212
(815) 741-0707
Mailing address
2000 GLENWOOD AVE, SUITE 100, JOLIET, IL 60435-5676
(815) 741-1212
(815) 741-0707
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036046328
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046328
—
IL
01
—
09932417
BCBS
IL
Enumeration date
11/16/2007
Last updated
11/02/2010
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