Vithida Sueblinvong, MD | |
840 S Wood St, M/c 856, Chicago, IL 60612-4325 | |
(312) 996-6605 | |
(312) 413-3373 |
Full Name | Vithida Sueblinvong |
---|---|
Gender | Female |
Speciality | Pediatrics - Pediatric Cardiology |
Location | 840 S Wood St, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134193121 | NPI | - | NPPES |
36099389 | Medicaid | IL | |
K09585 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0202X | Pediatrics - Pediatric Cardiology | 36099389 (Illinois) | Primary |
Entity Name | The Board Of Trustees Of The University Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
Mailing Address | Practice Location Address |
---|---|
Vithida Sueblinvong, MD 840 S Wood St, M/c 856, Chicago, IL 60612-4325 Ph: (312) 996-6605 | Vithida Sueblinvong, MD 840 S Wood St, M/c 856, Chicago, IL 60612-4325 Ph: (312) 996-6605 |
Nupur Mittal, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1725 W. Harrison St Suite 710, Rush University Medical Center,, Chicago, IL 60612 Phone: 312-942-5983 Fax: 312-563-2519 | |
Dr. Gustave Falciglia, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave # 45, Chicago, IL 60611 Phone: 312-227-4190 | |
Bessey Elizabeth Jose Geevarghese, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 225 E Chicago Ave, Chicago, IL 60611 Phone: 630-933-6631 | |
Bernadeta Leegan Wibisono, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2951 S King Dr Apt 1004, Chicago, IL 60616 Phone: 312-351-1346 | |
Allie Dakroub, MD MS Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5841 S Maryland Ave, Chicago, IL 60637 Phone: 773-702-1000 | |
Ajay Bhasin, Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 251 E Huron St, Chicago, IL 60611 Phone: 312-926-5924 | |
Kyle L Macquarrie, MD PHD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave # 30, Chicago, IL 60611 Phone: 312-227-4000 |