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Contact Information

ETHAN UNGCHUSRI
5841 S MARYLAND AVE
CHICAGO, IL60637
 Phone: 773-702-3550
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ETHAN UNGCHUSRI · (Male)

NPI # 1437656683
Status Active
Credentials
Entity Individual
Enumeration date 04/12/2018
Last updated 09/05/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036171306
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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