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Organization

JESS BROWN VAMC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PENG LIANG HUANG M.D. (ATTENDING PHYSICIAN)
(312) 569-6127
Entity
Organization

Contact information

Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6127
(312) 569-6148
Mailing address
54 OAK CREEK COURT, BURR RIDGE, IL 60527
(630) 323-0357

Taxonomy

Speciality
Code
Description
License number
State
2865M2000X
Military General Acute Care Hospital
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36051659
IL
Enumeration date
08/20/2006
Last updated
07/21/2022
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