Individual
DR. KOH OKAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 S PAULINA ST, SUITE 143, CHICAGO, IL 60612-3806
(312) 942-2061
Mailing address
600 S PAULINA ST, SUITE 143, CHICAGO, IL 60612-3806
(808) 599-0681
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125063867
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2010
Last updated
06/24/2013
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