Montha Suphangul, MD - Internal Medicine in Evanston, IL

Montha Suphangul, MD is a Internal Medicine physician based in Evanston, Illinois. Montha Suphangul is licensed to practice in Illinois (license number 125052160) and her current practice location is 355 Ridge Ave, Evanston, Illinois. She can be reached at her office (for appointments etc.) via phone at (847) 316-4000.

NPI number for Montha Suphangul is 1548424229 and her current mailing address is 429 Custer Ave Apt 2g, Evanston, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1548424229.

Contact Information

Montha Suphangul, MD
355 Ridge Ave,
Evanston, IL 60202-3328
(847) 316-4000
Not Available

Map and Direction




Physician's Profile

Full NameMontha Suphangul
GenderFemale
SpecialityInternal Medicine
Location355 Ridge Ave, Evanston, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1548424229
  • Provider Enumeration Date: 07/11/2008
  • Last Update Date: 07/11/2008

Medical Identifiers

Medical identifiers for Montha Suphangul such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548424229NPI-NPPES
XOF839694314OtherILBLUECROSS BLUESHIELD PPO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 125052160 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Montha Suphangul is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Montha Suphangul, MD
429 Custer Ave Apt 2g,
Evanston, IL 60202-2975

Ph: (773) 273-5968
Montha Suphangul, MD
355 Ridge Ave,
Evanston, IL 60202-3328

Ph: (847) 316-4000

Reviews and Comments


Internal Medicine Doctors in Evanston, IL

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Matthew R. Sherwood, MD
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Phone: 847-570-1010    Fax: 847-733-5128
Mina Kerolos, MD, PHARM.D.
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Phone: 847-864-3278    
Dipika Oberoi, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 2650 Ridge Ave, Evanston, IL 60201
Phone: 847-570-2700    

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