Individual
SOPHIA PENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
(646) 269-4943
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036161119
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2019
Last updated
12/27/2023
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