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1700915063
SUPACHAI S PONGCHED
CHICAGO, IL
NPI
1700915063
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Former Name
SUPACHAI SUWATANAPONGCHED
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: IL 036045385)
Enumeration Date
2007-03-05
Last Update Date
2007-07-08
Business Address
Dr. SUPACHAI S PONGCHED M.D.
11416 S MICHIGAN AVE
CHICAGO, IL 60628-4932
Phone number: 773-660-8515
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Mailing Address
Dr. SUPACHAI S PONGCHED M.D.
17315 UNIVERSITY AVE
SOUTH HOLLAND, IL 60473-3553
Phone number: 708-596-2445
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