Chotiprasidhi, Poonputt

Chotiprasidhi, Poonputt is an individual health care provider with primary practice located at 525 Valley View Dr , Moline IL 61265-6138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Chotiprasidhi, Poonputt can be contacted via phone (309) 601-2800.

Contact Information

Primary practice address
525 Valley View Dr Moline IL 61265-6138
Fax: (309) 601-2801
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 036103123 Illinois

Profile Details

NPI number 1558363713
LBN Legal business name Chotiprasidhi, Poonputt
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Apr 24th, 2019 - about 7 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1558363713 NPPES
Illinois MEDICAID 036103123
Illinois Other P00155422

Popular Providers