Sueblinvong, Vithida

Sueblinvong, Vithida is an individual health care provider with primary practice located at 840 S Wood St M/C 856, Chicago IL 60612-4325. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as her primary health care specialty. Sueblinvong, Vithida can be contacted via phone (312) 996-6605.

Contact Information

Primary practice address
840 S Wood St M/C 856 Chicago IL 60612-4325
Phone: (312) 996-6605
Fax: (312) 413-3373
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 36099389 Illinois

Profile Details

NPI number 1134193121
LBN Legal business name Sueblinvong, Vithida
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Dec 7th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134193121 NPPES
Illinois MEDICAID 36099389
Illinois MEDICAID K09585

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