Active NPI
Chanont Sricharoen
- Pediatrics Physician
- Park Ridge, IL
National Provider Identifier
1316797350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 1316797350
- Practice address
- 1675 Dempster St
Park Ridge, IL 60068-1110 - Phone
- (847) 318-9300
- NPI assigned
- Mar 25, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 1316797350 | IL | Primary |
Addresses
Primary practice location
1675 Dempster St
Park Ridge, IL 60068-1110
Mailing address
12922 Craig St
Omaha, NE 68142-1712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1316797350 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744416000000",
"number": "1316797350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12922 CRAIG ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681421712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 DEMPSTER ST",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681110",
"telephone_number": "847-318-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SRICHAROEN",
"first_name": "CHANONT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-25",
"last_updated": "2025-04-12",
"certification_date": "2025-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "1316797350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.