MEDICARE: JEERANUN CHOTEWATTANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1487547899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEERANUN CHOTEWATTANA

Provider Business Mailing Address
First Line	:	742 DEMPSTER ST APT B206
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-6125
Country	:	US
Telephone Number	:	847-274-8426
Fax Number	:

Provider Business Practice Location Address
First Line	:	3295 N ARLINGTON HEIGHTS RD STE 107
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1588
Country	:	US
Telephone Number	:	224-206-5001
Fax Number	:	224-400-6153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	01/20/2026

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Directions to “ JEERANUN CHOTEWATTANA ” Practice Location

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