DR. CHALONGCHAI PHITSANUWONG (NPI# 1245484740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245484740 |
| Entity Type | Individual |
| Full Name | DR. CHALONGCHAI PHITSANUWONG |
| Credential | M.D. |
| Practice Address |
5841 S Maryland Ave Mc 3055, Room 391 Chicago IL 60637-1447 |
| Mailing Address |
1130 S Michigan Ave Apartment 3913 Chicago IL 60605-2521 |
| Practice Telephone | 7738342259 |
| Mailing Telephone | 3125237325 |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2015-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
036135162 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICAL LICENSE | 036135162 | 01 |
| Street Address |
5841 S MARYLAND AVE MC 3055, ROOM 391 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60637-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700887296 | Rita Lynn Mcgill | Internal Medicine | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2005-08-09 |
| 1447851472 | Basirat Sulaiman | Nurse Practitioner | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-11-05 |
| 1982204061 | Martha Daniela Gorski | Nurse Practitioner | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-10-28 |
| 1841807179 | Jason Bugno | Pharmacist | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-09-30 |
| 1942816798 | Emily Mancewicz | Registered Nurse | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-09-17 |
| 1841805546 | Anayeli Locascio | Nurse Practitioner | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-09-10 |
| 1336752856 | Rachel Barsella | Registered Nurse | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-08-25 |
| 1982215620 | Jennifer Risner | Registered Nurse | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-08-16 |
| 1134739857 | Moshe Bedziner | Physician Assistant | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-08-06 |
| 1427676899 | Brittney Blackwell | Registered Nurse | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-07-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263234 | Pooja Ramnani | Pharmacist | 5841 S Maryland Ace, Chicago, IL 60637 | 2020-04-10 |
| 1780220079 | Tara Coleman | Non-emergency Medical Transport (VAN) | 808 E. 63rd Street, Suite 135, Chicago, IL 60637 | 2019-11-21 |
| 1366003501 | Valerie Silas | Case Management | 6330 S King Drive, Chicago, IL 60637 | 2019-06-27 |
| 1205391620 | Derek Joseph Fiedler | Anesthesiology | University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 | 2019-02-11 |
| 1821573072 | Ugochinyere Ohaja | Registered Nurse | 5656 South Maryland Avenue, Chicago, IL 60637 | 2018-10-03 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1558854695 | Rasidat Adeduntan | Internal Medicine | 5841 S. Maryland Avenue, [7082], Chicago, IL 60637 | 2018-06-13 |
| 1194235283 | Melissa Ann Arangoa | Registered Nurse | 5841 S. Maryland Ave, Mc 1083, Chicago, IL 60637 | 2017-10-03 |
| 1558880633 | Marni Harris | Optometrist | 5841 S Maryland Ave # S421, Chicago, IL 60637 | 2017-09-11 |
| 1992235105 | Vidya Mahavadi | Pediatrics | 5841 S. Maryland Avenue, Mail Code 8016, Chicago, IL 60637 | 2017-06-20 |
| Find all providers in zip 60637 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851558001 | Lubov Romantseva | Psychiatry & Neurology | 1725 W Harrison St Ste 718, Department of Pediatrics, Section of Child Neurology, Chicago, IL 60612-3863 | 2008-05-16 |
| 1356446306 | Leonard D Elkun Md Sc | Psychiatry & Neurology | 411 W Ontario St, Suite 402, Chicago, IL 60610-6945 | 2006-09-14 |
| 1023129145 | Leonard David Elkun | Psychiatry & Neurology | 411 W. Ontario St, Suite 402, Chicago, IL 60610-6945 | 2006-08-31 |
| 1811929003 | Charles Nash Swisher | Psychiatry & Neurology | 2515 N Clark Street, Suite, Chicago, IL 60614 | 2006-07-07 |
| 1578531950 | David G Ritacco | Psychiatry & Neurology | 225 E Chicago Ave # 51, Chicago, IL 60611-2991 | 2006-03-10 |
| 1386639342 | Audrius V Plioplys | Psychiatry & Neurology | 8844 S Pleasant Ave, Chicago, IL 60620-5441 | 2005-09-15 |
| 1720532773 | Adult and Pediatric Neurology | Psychiatry & Neurology | 5318 W Devon Ave, Chicago, IL 60646-4108 | 2016-08-08 |
| 1851785547 | Henry David | Psychiatry & Neurology | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2015-03-20 |
| 1972910404 | David Andrew Bieber | Psychiatry & Neurology | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2014-07-16 |
| 1992122410 | Divakar Mithal | Psychiatry & Neurology | 225 E Chicago Ave Dept Of, Chicago, IL 60611-2991 | 2014-03-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.