Individual
SHIWEN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1351 BARCLAY BLVD, BUFFALO GROVE, IL 60089
(224) 588-9940
(224) 588-9941
Mailing address
1439 W HARRISON ST, CHICAGO, IL 60607-3200
(312) 823-0657
(224) 588-9941
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36121319
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
A103106
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36121319
—
IL
Enumeration date
06/16/2009
Last updated
07/01/2019
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