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SURASAK PRATUANGTHAM MD
NPI 1639164601
Pediatrics - Pediatric Infectious Diseases in Oak Lawn, IL

Active since September 15, 2005
4440 W 95TH ST, OAK LAWN, IL 60453(708) 727-1267 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Surasak Pratuangtham Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SURASAK PRATUANGTHAM MD (NPI 1639164601) is an individual pediatric infectious diseases provider in Oak Lawn, Illinois, licensed in Illinois (036085443) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1639164601
Entity TypeIndividualMale
Primary Taxonomy2080P0208X
Provider Legal NameSURASAK PRATUANGTHAMCredential: MD
Location Address4440 W 95TH STOak Lawn, IL 60453-2600
Mailing Address8100 W 119th St Ste 400Palos Park, IL 60464-3080 · (708) 361-3300
Phone(708) 727-1267
Sole ProprietorNo
Enumeration DateSeptember 15, 2005
Last NPPES UpdateDecember 22, 2021
NPPES CertifiedDecember 22, 2021
✔ NPI 1639164601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Infectious DiseasesAllopathic & Osteopathic Physicians
Taxonomy Code2080P0208X
License✔ Licensed in IL · 036085443
Definition
A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.
4440 W 95TH ST, Oak Lawn, IL 60453
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Other Identifiers 4

Other25601IL · Advocate Hlth Partners Id
Medicaid036085443IL
Other01626483IL · Bcbs Provider Id
Medicaid200331500AIN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARK ADRIAN FAASSE MD
Urology
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-4557
DR. MANDY LUMA ENSHIWAT M.D.
Internal Medicine
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-8000
DR. KIM MARIE MIILLER MA, PSYD
Psychologist (Clinical)
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-7482
JENNIFER MARSIGLIO
Occupational Therapist (Physical Rehabilitation)
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-5425
TRACI LYNN TAGUE MA, CCC-SLP
Speech-Language Pathologist
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-1989
ELIZABETH A FOLLIARD OTR/L
Occupational Therapist
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-5369
MICHAEL CIRONE M.D.
Emergency Medicine
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-5375
ANNA MANILLA
Speech-Language Pathologist
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (248) 701-7523

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Surasak Pratuangtham's NPI number?

The NPI number for Surasak Pratuangtham is 1639164601. It was assigned to this individual provider in the NPPES registry on September 15, 2005.

Where is Surasak Pratuangtham located?

Surasak Pratuangtham practices at 4440 W 95th St, Oak Lawn, IL 60453. The listed phone number is (708) 727-1267.

What is Surasak Pratuangtham's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Infectious Diseases, with taxonomy code 2080P0208X.

When was this NPI record last updated?

The NPPES record for Surasak Pratuangtham was last updated on December 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.