Active NPI
Amnuay Sethakorn, MD
- Family Medicine Physician
- Gibson City, IL
National Provider Identifier
1386727642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 4 Doctors Park
Gibson City, IL 60936 - Phone
- (217) 784-8919
- NPI assigned
- Oct 23, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
4 Doctors Park
Gibson City, IL 60936
Mailing address
PO Box 527
4 Doctors Park
Gibson City, IL 60936
Phone (217) 784-8919
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036045962 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386727642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 527",
"address_2": "4 DOCTORS PARK",
"city": "GIBSON CITY",
"state": "IL",
"postal_code": "60936",
"telephone_number": "217-784-8919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 DOCTORS PARK",
"city": "GIBSON CITY",
"state": "IL",
"postal_code": "60936",
"telephone_number": "217-784-8919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SETHAKORN",
"first_name": "AMNUAY",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gibson City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.