Individual
NATHANIEL KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
840 S WOOD ST, SUITE 518-E, CHICAGO, IL 60612-4325
(312) 996-6765
Mailing address
1012 N WOOD ST UNIT 2, CHICAGO, IL 60622-3261
(847) 903-7507
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036133774
IL
2086S0120X
Pediatric Surgery Physician
Primary
036133774
IL
Other
Enumeration date
04/14/2008
Last updated
04/26/2021
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