Provider Demographics
NPI:1962202523
Name:PUTTARAT, CHRISTOPHER KEVIN
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:KEVIN
Last Name:PUTTARAT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-8667
Mailing Address - Country:US
Mailing Address - Phone:847-571-2045
Mailing Address - Fax:
Practice Address - Street 1:3042 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-8667
Practice Address - Country:US
Practice Address - Phone:847-571-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician