Individual
MYOUNGSU SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
819 BLOOMINGTON RD, CHAMPAIGN, IL 61820-2101
(217) 356-1558
Mailing address
2050 E ALGONQUIN RD STE 610, SCHAUMBURG, IL 60173-4166
(888) 988-4066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019032794
IL
Other
Enumeration date
08/12/2020
Last updated
01/24/2023
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