Individual
DR. KANRAMON WATTHANASUNTORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-2857
(312) 492-0025
Mailing address
2600 S MICHIGAN AVE STE 100, CHICAGO, IL 60616-2857
(312) 492-0025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036151093
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036151093
IL
Other
Enumeration date
06/23/2017
Last updated
06/20/2024
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