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1548424229
MONTHA SUPHANGUL
EVANSTON, IL
NPI
1548424229
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 125052160)
Enumeration Date
2008-07-11
Last Update Date
2008-07-11
Business Address
-- MONTHA SUPHANGUL M.D.
355 RIDGE AVE
EVANSTON, IL 60202-3328
Phone number: 847-316-4000
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Mailing Address
-- MONTHA SUPHANGUL M.D.
429 CUSTER AVE APT 2G
EVANSTON, IL 60202-2975
Phone number: 773-273-5968
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