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Niranat Dejtiranukul, MD
Otolaryngic Allergy Physician in Olney, Illinois
NPI 1013049212

Niranat Dejtiranukul is a Otolaryngic Allergy Physician based in Olney, IL and is specialized in Otolaryngic Allergy. Niranat Dejtiranukul practices in Olney, IL and has the professional credentials of MD. The NPI Number for Niranat Dejtiranukul is 1013049212 and holds a License No. 036-050750 (Illinois).

The current practice location address for Niranat Dejtiranukul is 800 E Locust St, Olney, IL and can be reached out via phone at 618-395-7340.

Location: 800 E Locust St, Olney, IL, 62450-0097
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013049212
Provider Name
Niranat Dejtiranukul
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
800 E Locust St, Olney, IL, 62450-0097
Phone Number
618-395-7340
Fax Number
Provider Enumeration Date
03/12/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
216183 01 MEDICARE PTAN
036050750 05 IL
08022315 01 IL BLUE CROSS/BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
800 E Locust St
City
Olney
State
Illinois
Zip
62450-2553
Phone Number
618-395-7340
Fax Number
person
Provider Business Mailing Address Details
Address
800 E Locust St
City
Olney
State
Illinois
Zip
62450-2553
Phone Number
618-395-7340
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
-
Taxonomy
207Y00000X
License No.
036-050750 (Illinois)
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
Otolaryngic Allergy
Taxonomy
207YX0602X
License No.
036-050750 (Illinois)
Definition
An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases.
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