Guntippar S Pratumngern, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-105741 Issued in IL

Practice address

7255 N Caldwell Ave
Niles, IL 60714-4501

Phone

(847) 647-0355

Fax

(847) 647-7638

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr 247 SC

  • Family Medicine Physician
  • Buffalo Grove, IL
  • NPI 1922669670
  Medicare reassignment NPD
• Mobile Wound Care Corp

  • Vascular Surgery Physician
  • Buffalo Grove, IL
  • NPI 1811866080
  Medicare reassignment NPD
• Bonaventure Medical Foundation, LLC

  dba Alexian Brothers Medical Foundation

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1306967724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 N CALDWELL AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144501",
            "telephone_number": "847-647-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 N CALDWELL AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144501",
            "telephone_number": "847-647-0355",
            "fax_number": "847-647-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATUMNGERN",
        "first_name": "GUNTIPPAR",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": "336066466",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-105741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shailaja Potdar, MD
• Monica Potempa (Maso)
• James S Poulos, MD
• John D Poulos, DC
• Rebecca Powers
• Precision Radiation Medicine LLC (Precision Radiation Medicine)
• Presence RHC Senior Services (Presence Saint Andrew Life Center)
• Presence Senior Services Chicagoland (Ascension Living Saint Benedict Village)
• Priya Shah DDS PLLC (Shanti Dental)
• Pro Body Wellness Inc

• Family Medicine Physician in Niles, IL
• Providers in Niles, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.