Organization
LOGAN SQUARE URGENT CARE CENTER CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YONGSOO KWON M.D. (PHYSICIAN)
(773) 772-8876
Entity
Organization
Contact information
Practice address
2004 N PULASKI RD, CHICAGO, IL 60639-3767
(773) 772-8876
(773) 252-3091
Mailing address
2004 N PULASKI RD, CHICAGO, IL 60639-3767
(773) 772-8876
(773) 252-3091
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036070641
IL
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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