PANOM PHOUNGCHERDCHOO (NPI# 1366496564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366496564 |
| Entity Type | Individual |
| Full Name | PANOM PHOUNGCHERDCHOO |
| Credential | M.D. |
| Practice Address |
8311 Roosevelt Rd Forest Park IL 60130-2529 |
| Mailing Address |
1745 Pavilion Way Unit 207 Park Ridge IL 60068-1163 |
| Practice Telephone | 7087717000 |
| Mailing Telephone | 8476983470 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2017-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
036045322 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036045322 | 05 |
| Street Address |
8311 ROOSEVELT RD |
| City | FOREST PARK |
| State | IL |
| Zip Code | 60130-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457337735 | Sheila Casteel | Behavioral Analyst | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2005-12-19 |
| 1831702984 | Bailey Katz | Counselor | 8311 Roosevelt Rd, Forest Park, IL 60130-2500 | 2020-08-28 |
| 1932726569 | Kristen Mccourt | Nurse Practitioner | 8311 Roosevelt Rd, Forest Park, IL 60130-2500 | 2020-06-30 |
| 1376183293 | Jessica Huerta | Counselor | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2020-01-08 |
| 1801436969 | Annie Merab Arnold | Counselor | 8311 Roosevelt Rd, Forest Park, IL 60130-2500 | 2020-01-07 |
| 1073151718 | Sarah Martinez | Social Worker | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2019-12-12 |
| 1396386686 | Kate Naudin | Counselor | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2019-10-08 |
| 1366094799 | Cara E. Paden | Music Therapist | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2019-07-16 |
| 1730641135 | Erin Mckenney | Psychologist | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2019-04-03 |
| 1922567908 | Bridget Springmire | Psychologist | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2019-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740828227 | Amanda Ross | Social Worker | 1037 Desplaines Avenue, Unit 607, Forest Park, IL 60130 | 2019-12-16 |
| 1639733959 | Pop Pediatric Therapy Services, LLC | Occupational Therapy Assistant | Pop Pediatric Therapy, 7421 Madison Ave., Forest Park, IL 60130 | 2019-04-23 |
| 1194261776 | Emeryle D Ladd | Driver | 1117 S. Harlem, Unit 1, Forest Park, IL 60130 | 2017-01-06 |
| 1225381106 | Riveredge Hospital | Clinic/Center | 8311 W Roosevelt Road, Forest Park, IL 60130 | 2012-10-17 |
| 1033479712 | Debra L Jensen | Acupuncturist | 7314 W. Madison, Forest Park, IL 60130 | 2012-05-29 |
| 1710289327 | Platinum Dental Care | Health Maintenance Organization | 333 Circle Avenue, Forest Park, IL 60130 | 2010-12-02 |
| 1174857262 | Anwar Adams | Physical Therapy Assistant | 1029 Des Plaines Ave Apt 601, Forest Park, IL 60130 | 2009-09-23 |
| 1992939318 | Family Health Solutions,pc | Chiropractor | 315 Des Plaines Ave., Suite 307, Forest Park, IL 60130 | 2009-05-13 |
| 1235386681 | Arnold Clevs | Dentist | 334 Circle Ave, Forest Park, IL 60130 | 2008-08-27 |
| 1932376167 | Dianella V Dizon-menezes | Psychiatry & Neurology | 8311 W Roosevelt Rd, Advanced Psychiatric Services, Forest Park, IL 60130 | 2008-05-16 |
| Find all providers in zip 60130 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932376167 | Dianella V Dizon-menezes | Psychiatry & Neurology | 8311 W Roosevelt Rd, Advanced Psychiatric Services, Forest Park, IL 60130 | 2008-05-16 |
| 1831505106 | Indupreet Nagra | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130 | 2014-07-08 |
| 1427353184 | Richard S. Goldberg, M.d., Ltd. | Psychiatry & Neurology | 8311 Roosevelt Rd, Optional, Forest Park, IL 60130-2529 | 2011-01-11 |
| 1578686432 | Daniel O Faisal | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2007-04-07 |
| 1356432967 | Midwest Psychiatry Associates Sc | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2006-09-27 |
| 1487745006 | Humaira F Saiyed | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2006-09-27 |
| 1245336205 | Aamir Safdar | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2006-09-16 |
| 1215982509 | Advanced Psychiatric Services Sc | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2006-05-24 |
| 1568417996 | Ralph Menezes | Psychiatry & Neurology | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840659 | Amelia Mari Merz | Psychiatry & Neurology | 1101 Lake St Ste 201b, Oak Park, IL 60301-1046 | 2020-10-27 |
| 1063024925 | Mindful Psychiatric Care LLC | Psychiatry & Neurology | 120 E Ogden Ave Ste 101, Hinsdale, IL 60521-3892 | 2020-08-20 |
| 1053921296 | Healing Hands Resource Center | Psychiatry & Neurology | 6607 W Main St, Belleville, IL 62223-3025 | 2020-08-03 |
| 1144848086 | Zachary A Kordik Md PC | Psychiatry & Neurology | 25 E Washington St Ste 904, Chicago, IL 60602-1715 | 2020-07-07 |
| 1629694278 | Montes Psychiatric Center, P.C. | Psychiatry & Neurology | 717 Trent Ln, Loves Park, IL 61111-8956 | 2020-06-19 |
| 1659996767 | Bluesky Telepsych | Psychiatry & Neurology | 4753 N Broadway St Ste 910, Chicago, IL 60640-4991 | 2020-06-15 |
| 1164047833 | Advanced Psychiatry Clinics, S.c. | Psychiatry & Neurology | 5519 N Cumberland Ave Ste 1016, Chicago, IL 60656-1480 | 2020-06-09 |
| 1326661802 | Psychmed Clinic Inc | Psychiatry & Neurology | 2159 W Madison St, Chicago, IL 60612-2307 | 2020-05-19 |
| 1467074534 | Holmes Psychiatry LLC | Psychiatry & Neurology | 2027 W Division St # 144, Chicago, IL 60622-9024 | 2020-05-12 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| Find all providers with the same taxonomy | ||||
| City | FOREST PARK |
| Zip Code | 60130 |
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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.