Organization
BROADWAY MEDICAL OFFICE S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAN DUONG MD (OWNER)
(773) 878-4800
Entity
Organization
Contact information
Practice address
5449 N BROADWAY ST, CHICAGO, IL 60640-1703
(773) 878-4800
Mailing address
5449 N BROADWAY ST, CHICAGO, IL 60640-1703
(773) 878-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
04/11/2007
Last updated
04/21/2015
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