Individual
KWANG M JANG
Active
Individual
KWANG M JANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036132637
IL
207R00000X
Internal Medicine Physician
125056216
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036132637
IL PERMANENT LICENSE
IL
01
—
125056216
IL STATE LICENSE # 125056216
IL
Enumeration date
08/28/2009
Last updated
09/25/2013
Update your record
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