Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pornthep Prathanvanich, MD

Individual provider Surgery Physician · NPI 1093109308

Pornthep Prathanvanich, MD is a Surgery Physician in Maywood, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (888) 584-7888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 125066961 (IL)

Record details

NPI number1093109308
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 25, 2015
Last updated in NPPESMay 29, 2015

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