Souphone Pone Rattana, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

051288178 Issued in IL

Practice address

474 W Commonwealth LN
Elmhurst, IL 60126-4954

Phone

(630) 941-1688

NPI assigned

Mar 11, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1699233486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 W COMMONWEALTH LN",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264954",
            "telephone_number": "630-941-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 W COMMONWEALTH LN",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264954",
            "telephone_number": "630-941-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTANA",
        "first_name": "SOUPHONE",
        "middle_name": "PONE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051288178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jane Ramos, NP-C
• Robert L Randall, PH,D.
• Ahmad O Raslan, MD
• Tayyiba Rasool
• Logan Rattana
• Nicholas Rauh, MD
• Robert Andrew Rauh, MD
• Raymond V Janevicius MD PC
• Mary L Raymond, PT, DHS, MS
• Leena Raza, MD

• Pharmacist in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.