Active NPI
Amornrat Sawangkum, MD
- Pediatrics Physician
- Chicago, IL
National Provider Identifier
1407699606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 125.084015
- Practice address
- 1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227 - Phone
- (312) 942-0312
- NPI assigned
- Jun 15, 2024
- Sex
- Female
- 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 | 125.084015 | IL | Primary |
Addresses
Primary practice location
1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227
Mailing address
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240821001358 | IL | Order and Referring Only - Pediatric Medicine | 2365980380 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.084015 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1407699606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S PAULINA ST STE 403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 W JACKSON BLVD STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123227",
"telephone_number": "312-942-0312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAWANGKUM",
"first_name": "AMORNRAT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-15",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125.084015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.