Niranat Dejtiranukul, MD - Otolaryngology in Olney, IL

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Niranat Dejtiranukul, MD is a Otolaryngology physician based in Olney, Illinois. Niranat Dejtiranukul is licensed to practice in Illinois (license number 036-050750) and his current practice location is 800 E Locust St, Olney, Illinois. He can be reached at his office (for appointments etc.) via phone at (618) 395-7340.

NPI number for Niranat Dejtiranukul is 1013049212 and his current mailing address is Po Box 97, Olney, Illinois. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1013049212.

Contact Information

Niranat Dejtiranukul, MD
800 E Locust St,
Olney, IL 62450-2553
(618) 395-7340
Not Available

Map and Direction




Physician's Profile

Full NameNiranat Dejtiranukul
GenderMale
SpecialityOtolaryngology
Location800 E Locust St, Olney, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1013049212
  • Provider Enumeration Date: 03/12/2007
  • Last Update Date: 10/28/2011

Medical Identifiers

Medical identifiers for Niranat Dejtiranukul such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013049212NPI-NPPES
216183OtherMEDICARE PTAN
036050750MedicaidIL
08022315OtherILBLUE CROSS/BLUE SHIELD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Y00000XOtolaryngology 036-050750 (Illinois)Primary
207YX0602XOtolaryngology - Otolaryngic Allergy 036-050750 (Illinois)Secondary

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. Niranat Dejtiranukul 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
Niranat Dejtiranukul, MD
Po Box 97,
Olney, IL 62450-0097

Ph: (618) 395-7340		Niranat Dejtiranukul, MD
800 E Locust St,
Olney, IL 62450-2553

Ph: (618) 395-7340

Reviews and Comments


Otolaryngology Doctors in Olney, IL


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