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Sariya Prachukthum, MD
Student in an Organized Health Care Education/Training Program in Chicago, Illinois
NPI 1750693412

Sariya Prachukthum is a Student in an Organized Health Care Education/Training Program based in Chicago, IL. Sariya Prachukthum practices in Chicago, IL and has the professional credentials of MD. The NPI Number for Sariya Prachukthum is 1750693412 and holds a License No. 125058319 (Illinois).

The current practice location address for Sariya Prachukthum is 1450 E 55Th Pl # 421, Chicago, IL and can be reached out via phone at 312-810-8922.

Location: 1450 E 55Th Pl # 421, Chicago, IL, 60637-1877
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Provider Profile Details
NPI Number
1750693412
Provider Name
Sariya Prachukthum
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1450 E 55Th Pl # 421, Chicago, IL, 60637-1877
Phone Number
312-810-8922
Fax Number
Provider Enumeration Date
07/11/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
125058319 05 IL
institution
Provider Business Practice Location Address Details
Address
1450 E 55Th Pl # 421
City
State
Zip
60637-1877
Phone Number
312-810-8922
Fax Number
person
Provider Business Mailing Address Details
Address
1450 E 55Th Pl # 421
City
State
Zip
60637-1877
Phone Number
312-810-8922
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
125058319 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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