KAJORNDEJ KOMUTANON MD SC (NPI# 1710153762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710153762 |
| Entity Type | Organization |
| Organization Name | KAJORNDEJ KOMUTANON MD SC |
| Practice Address |
3218 W Lawrence Avenue Chicago IL 60625-5209 |
| Mailing Address |
6543 W Albert Avenue Morton Grove IL 60053-1402 |
| Practice Telephone | 7735886846 |
| Practice Fax Number | 7735886847 |
| Mailing Telephone | 8479661957 |
| Mailing Fax Number | 8479661957 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |
| Authorized Official Name | MR. KAJORNDEJ KOMUTANON (PRESIDENT) |
| Authorized Official Telephone | 8479661957 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
036046966 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036046966 | 05 |
| Street Address |
3218 W LAWRENCE AVENUE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60625-5209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952468985 | Rapeepan S Komutanon | Pediatrics | 3218 W Lawrence Avenue, Chicago, IL 60625 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726615 | B Wise Rehabilitation Pllc | Physical Therapist | 4754 N Lincoln Ave, Fl 1, Chicago, IL 60625 | 2020-10-07 |
| 1700490448 | Anita Saini | Pharmacist | 5140 N California Ave, Chicago, Il 60625, Chicago, IL 60625 | 2020-09-01 |
| 1699303164 | Marina Karamanis | Student in an Organized Health Care Education/Training Program | Swedish Hospital, 5140 N. California Ave, Chicago, IL 60625 | 2020-03-31 |
| 1063050227 | Jacqueline Guadalupe Saldana | Behavioral Analyst | 8616 W Catalpa Ave, Suite 1106, Chicago, IL 60625 | 2019-12-18 |
| 1912557802 | Six Senses Therapy LLC | Social Worker | 2334 W. Lawrence Avenue, Suite 204c, Chicago, IL 60625 | 2019-09-13 |
| 1982266110 | Noreen Randhawa | Family Medicine | Swedish Hospital Part of North Shore, 5145 N. California Ave., Chicago, IL 60625 | 2019-07-09 |
| 1376102202 | Nita Gupta | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Department, 5145 N. California Ave, Chicago, IL 60625 | 2019-06-13 |
| 1841763471 | Alexandra Taskier | Counselor | 5359 N Bowmanville Ave., Chicago, IL 60625 | 2019-01-07 |
| 1013490143 | Paula Bielnicka | Pharmacist | Swedish Covenant Hospital - Pharmacy, 5140 N California Ave, Chicago, IL 60625 | 2018-09-14 |
| 1902397078 | Rebecca Abraham | Hospitalist | 5145 N California Ave Ofc M331, Chicago, IL 60625 | 2018-05-24 |
| Find all providers in zip 60625 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457479420 | Progressive Institute of Allergy, Inc. | Allergy & Immunology | 5351 W Lawrence Ave, Chicago, IL 60630-3627 | 2007-03-27 |
| 1164439253 | Laura Rogers Allergy & Asthma, M.d., S.c. | Allergy & Immunology | 233 E Erie St Ste 810, Chicago, IL 60611-2906 | 2006-08-02 |
| 1972519320 | Edward E Lisberg | Allergy & Immunology | 1912 N Leavitt St, Chicago, IL 60647-4409 | 2006-07-31 |
| 1528069804 | Kajorndej Komutanon | Allergy & Immunology | 3218 W Lawrence Ave, Chicago, IL 60625-5209 | 2005-08-09 |
| 1043536832 | Fei Li Kuang | Allergy & Immunology | 675 N Saint Clair St Ste 18-250, Chicago, IL 60611-5980 | 2010-04-19 |
| 1437329794 | Athanasios Konstantinidis | Allergy & Immunology | 251 E Huron St, Galter Building, 18th Floor, Chicago, IL 60611-2908 | 2008-03-03 |
| 1831276872 | Anne Ditto | Allergy & Immunology | 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611-4546 | 2006-11-01 |
| 1285662304 | Brian Rotskoff | Allergy & Immunology | 4801 W Peterson Ave, Suite 306, Chicago, IL 60646-5713 | 2006-06-29 |
| 1487690285 | Leslie Grammer | Allergy & Immunology | 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611-4546 | 2006-06-21 |
| 1508811621 | Julio Lara-valle | Allergy & Immunology | 1859 W Chicago Ave, Chicago, IL 60622-5513 | 2006-05-24 |
| Find all providers in CHICAGO | ||||
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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.