Individual
PENG JI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
420 E SUPERIOR ST, RUBLOFF BUILDING 12-172, CHICAGO, IL 60611-4494
(312) 503-4756
Mailing address
303 E CHICAGO AVE, WARD 3-140, CHICAGO, IL 60611-4296
(617) 901-5198
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
125-058983
IL
Other
Enumeration date
09/16/2010
Last updated
02/01/2017
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