Preecha Tawjareon, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Practice address

815 W Main St
Salem, IL 62881-0875

Phone

(618) 548-2843

Fax

(618) 548-2896

NPI assigned

Mar 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1386773604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W MAIN ST",
            "address_2": "PO BOX 875",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628810875",
            "telephone_number": "618-548-2843",
            "fax_number": "618-548-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W MAIN ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628810875",
            "telephone_number": "618-548-2843",
            "fax_number": "618-548-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWJAREON",
        "first_name": "PREECHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-04",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORA PIN #",
            "identifier": "P04756",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0006115210",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SALEM PIN #",
            "identifier": "L06343",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF1003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evonne Lanae Stephenson, M.S., LCPC
• James B Stiehl, MD
• Palaniappan Suppiah, MD
• Piodel Balgos Susmena, PT
• Sharon Sue Szatkowski, APRN
• The Adjustment Bureau PC
• The Manor at Salem Woods, L.P.
• Megan Thomann
• Thomas H. Nolen, D.P.M.,P.C.
• Heidi V. Thompson, FNP-BC

• Diagnostic Radiology Physician in Salem, IL
• Providers in Salem, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.