person
Thidaporn Iamsutta, QMHP
Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, Illinois
NPI 1972001709

Thidaporn Iamsutta is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Chicago, IL and is specialized in Mental Health (Including Community Mental Health Center). Thidaporn Iamsutta practices in Chicago, IL and has the professional credentials of QMHP. The NPI Number for Thidaporn Iamsutta is 1972001709 and holds a License No. (Illinois).

The current practice location address for Thidaporn Iamsutta is 4753 N Broadway St Ste 700, Chicago, IL and can be reached out via phone at 773-293-8430 and via fax at 773-728-4751.

Location: 4753 N Broadway St Ste 700, Chicago, IL, 60640-4995
person
Provider Profile Details
NPI Number
1972001709
Provider Name
Thidaporn Iamsutta
Credential
QMHP
Provider Entity Type
Individual
Gender
Female
Address
4753 N Broadway St Ste 700, Chicago, IL, 60640-4995
Phone Number
773-293-8430
Fax Number
773-728-4751
Provider Enumeration Date
01/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4753 N Broadway St Ste 700
City
State
Zip
60640-4995
Phone Number
773-293-8430
Fax Number
773-728-4751
person
Provider Business Mailing Address Details
Address
4753 N Broadway St Ste 700
City
State
Zip
60640-4995
Phone Number
773-293-8430
Fax Number
773-728-4751
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
()
Definition
Definition to come...
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