MEDICARE: DR. PISIT RANGSITHIENCHAI M.D.

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	207K00000X	Allergy & Immunology Physician	36-48818	IL
2	174400000X	Specialist	36-48818	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982718912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PISIT RANGSITHIENCHAI M.D.

Provider Business Mailing Address
First Line	:	1809 CARDINAL CT
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 VICTORIA DR
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-2134
Country	:	US
Telephone Number	:	708-687-7550
Fax Number	:	708-687-7552

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	05/05/2024

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