Kajorndej Komutanon, MD

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

036046966 Issued in IL

Practice address

3218 W Lawrence Ave
Chicago, IL 60625-5209

Phone

(773) 588-6846

Fax

(733) 588-6847

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385683200000",
    "number": "1528069804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6543 W ALBERT AVENUE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600531402",
            "telephone_number": "847-966-1957",
            "fax_number": "773-588-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606255209",
            "telephone_number": "773-588-6846",
            "fax_number": "733-588-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMUTANON",
        "first_name": "KAJORNDEJ",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036046966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036046966",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Komornik, PA
• Allison S Komorowski, MD
• Mary Ann Komperda
• Aikaterini Kompoliti, MD
• Krystyna Komuniecki, PI
• Rapeepan S Komutanon, MD
• Alicia Kon, LCPC
• Rybecca Kon
• Anne Konchan, NP
• Neil Kondamuri

• Allergy Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Allergy Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2013; 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.