Pornthep Prathanvanich, M.D.

NPI #1093109308 in Maywood, Illinois

Provider Information

NPI Number: 1093109308
Entity Type: Individual
Name: Pornthep Prathanvanich, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Surgery
Credential: M.D.
Enumeration Date: Mar 25, 2015
Last Updated: May 29, 2015

Practice Location

Address: 2160 S 1ST AVE
City: Maywood
State: Illinois
ZIP Code: 60153-3328
Phone: (888) 584-7888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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