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Organization
KORLE BU MEDICAL GROUP
Active
Organization
KORLE BU MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ACQUAYE-AWAH M.D (PRESIDENT)
(773) 643-0400
Entity
Organization
Contact information
Practice address
5517 S. ELLIS AVE, CHICAGO, IL 60637
(773) 643-0400
(773) 643-0640
Mailing address
9033 RESERVE DR, WILLOW SPRINGS, IL 60480-1655
(773) 643-0400
(773) 643-0640
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
152W00000X
Optometrist
—
—
183500000X
Pharmacist
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
213E00000X
Podiatrist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
07/09/2006
Last updated
09/11/2025
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