| Chanachai Memark, MD | |
|
430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | |
| (630) 469-9200 | |
| Not Available |
| Full Name | Chanachai Memark |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 430 Pennsylvania Ave, Glen Ellyn, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336116771 | NPI | - | NPPES |
| 03046760 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 036046760 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Chanachai Memark, MD 1860 Paysphere Cir, Chicago, IL 60674-0018 Ph: (630) 469-9200 | Chanachai Memark, MD 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 Ph: (630) 469-9200 |
Dr. Ainah Uy Tan, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 430 Pennsylvania Ave # 180, Glen Ellyn, IL 60137 Phone: 630-469-9200 Fax: 630-545-7817 | |
Michelle A Pipitone, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 885 Roosevelt Rd, Glen Ellyn, IL 60137 Phone: 630-315-6500 Fax: 630-315-6519 |