Individual
AUTUMN SEUNGHEE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1801 W TAYLOR ST, CHICAGO, IL 60612-4795
(312) 413-7500
(312) 413-3856
Mailing address
820 S WOOD ST # MC808, CHICAGO, IL 60612-4325
(312) 996-7006
(312) 996-4238
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
209021694
IL
Other
Enumeration date
10/14/2020
Last updated
03/11/2022
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