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Organization

SOUTHWEST DERMATOLOGY

Active
Parent organization
SOUTHWEST DERMATOLOGY
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHWEST DERMATOLOGY
Authorized official
CHEUK W YUNG M.D. (M.D./)
(815) 463-8989
Entity
Organization

Contact information

Practice address
1870 SILVER CROSS BOULEVARD, SUITE 250, NEW LENOX, IL 60451
(815) 463-8989
(815) 463-8948
Mailing address
1870 SILVER CROSS BOULEVARD, SUITE 250, NEW LENOX, IL 60451
(815) 463-8989
(815) 463-8948

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
36059742
IL
207N00000X
Dermatology Physician
36111373
IL
207N00000X
Dermatology Physician
36116569
IL

Other

Enumeration date
05/16/2011
Last updated
06/21/2011
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