IndividualActive
Sirisak Suntharasantic, MD
NPI 1114083888 · Pediatrics Physician · Alton, IL
Provider details
- NPI number
- 1114083888
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036048367 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4 Memorial Dr Ste 210
Alton, IL 62002-6751
Phone: (618) 463-0649
Fax: (618) 463-3390
Approximate (ZIP-level) locationGet directions
Mailing address
4 Memorial Dr Ste 210
Alton, IL 62002-6751
Registry dates
- Enumerated
- 2006-12-28
- Last updated
- 2018-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.