Individual
MR. SAMUEL OPPONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6305 WOODWARD AVE, DOWNERS GROVE, IL 60516-2311
(630) 506-3530
(630) 512-0895
Mailing address
6305 WOODWARD AVE, DOWNERS GROVE, IL 60516-2311
(630) 506-3530
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
015278076119
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871289761
—
IL
Enumeration date
12/15/2022
Last updated
12/15/2022
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