Individual
KENNY S. YOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2520 ELISHA AVE, ZION, IL 60099-2676
(800) 322-9183
Mailing address
PATIENT FIRST 2361 PAYSPHERE CIRCLE, CHICAGO, IL 60674-0001
(800) 322-9183
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036106402
IL
2085R0202X
Diagnostic Radiology Physician
77895
WI
2085R0202X
Diagnostic Radiology Physician
C171364
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036.106402
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.106402
STATE LICENSE
IL
05
—
036106402
—
IL
Enumeration date
12/09/2005
Last updated
03/11/2024
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