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Dr. Supachai S Pongched, MD
Obstetrics & Gynecology Physician in Chicago, Illinois
NPI 1700915063

Supachai S Pongched is a Obstetrics & Gynecology Physician based in South Holland, IL. Supachai S Pongched practices in Chicago, IL and has the professional credentials of MD. The NPI Number for Supachai S Pongched is 1700915063 and holds a License No. (Illinois).

The current practice location address for Supachai S Pongched is 11416 S Michigan Ave, Chicago, IL and can be reached out via phone at 773-660-8515 and via fax at 630-455-9633.

Location: 11416 S Michigan Ave, Chicago, IL, 60473-3553
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700915063
Provider Name
Supachai S Pongched
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
11416 S Michigan Ave, Chicago, IL, 60473-3553
Phone Number
773-660-8515
Fax Number
630-455-9633
Provider Enumeration Date
03/05/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP5130543 01 IL D.E.A.
institution
Provider Business Practice Location Address Details
Address
11416 S Michigan Ave
City
Chicago
State
Illinois
Zip
60628-4932
Phone Number
773-660-8515
Fax Number
630-455-9633
person
Provider Business Mailing Address Details
Address
11416 S Michigan Ave
City
Chicago
State
Illinois
Zip
60628-4932
Phone Number
773-660-8515
Fax Number
630-455-9633
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
-
Taxonomy
207V00000X
License No.
(Illinois)
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
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