Sampanta Boonjarern
Nephrologist
297 Franciscan Dr
Crown Point
, Indiana 46307-4858
Sampanta Boonjarern
Nephrologist
297 Franciscan Dr
Crown Point
, Indiana 46307-4858
(708) 763-0970
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Sampanta Boonjarern
- 855 Madison St
- Oak Park, IL
- Zip : 60302-4420
- Fax : (708) 763-0970
- Phone : (708) 492-4531
Second Address
- Sampanta Boonjarern
- 297 Franciscan Dr
- Crown Point, IN
- Zip : 46307-4858
- Phone : (219) 622-1718
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FAQs
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Is Sampanta Boonjarern a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | 01027321A | IN |
National Provider Identifier
| NPI | 1073514642 |
|---|---|
| Provider Name | Sampanta Boonjarern |
| First Address | Oak Park, IL 60302-4420 |
| Second Address | Crown Point, IN 46307-4858 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/08/2005 |
| Last Update Date | 05/10/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000095595 | ANTHEM BCBS NUMBER (01) | IN |
| 090001077 | IL BCBS NUMBER (01) | IL |
| 100082060 | (05) | IN |
| 100168430A | (05) | IN |
| E05578 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.