Suntharasantic, Sirisak
Suntharasantic, Sirisak is an individual health care provider with primary practice located at 4 Memorial Dr Ste 210 , Alton IL 62002-6751. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Suntharasantic, Sirisak can be contacted via phone (618) 463-0649.Contact Information
Primary practice address
4 Memorial Dr Ste 210
Alton IL 62002-6751
Phone: (618) 463-0649
Fax: (618) 463-3390
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036048367 | Illinois |
Profile Details
| NPI number | 1114083888 |
|---|---|
| LBN Legal business name | Suntharasantic, Sirisak |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2006 |
| Last updated | May 3rd, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114083888 | NPPES |
| Illinois | MEDICAID | 036048367 |
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