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Contact Information

SITSADAPHONE PHETCHAMPHONE, DC
1157 W 18TH ST
CHICAGO, IL60608
 Phone: 312-344-1632
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for SITSADAPHONE PHETCHAMPHONE · (Male)

NPI Number 1780739284
Status Active
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 01/24/2007
Last updated 02/08/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 038-010281
  • IL License # 038010281
  • IL Other 2232625 BLUE CROSS BLUE SHIELD
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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