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1285675058
PUANGPETH - JANTRA
CHICAGO, IL
NPI
1285675058
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: IL 036-052761)
Enumeration Date
2006-06-10
Last Update Date
2007-07-08
Business Address
Dr. PUANGPETH - JANTRA M.D.
820 S DAMEN AVE
CHICAGO, IL 60612-3728
Phone number: 312-569-6380
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Mailing Address
Dr. PUANGPETH - JANTRA M.D.
4202 YORKSHIRE LN
NORTHBROOK, IL 60062-2917
Phone number: 847-480-9069
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