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Organization

SOUTHWEST DERMATOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHEUK W YUNG M.D. (PRESIDENT)
(815) 434-7231
Entity
Organization

Contact information

Practice address
410 W MAIN ST, OTTAWA, IL 61350-2802
(815) 434-7231
(815) 434-3549
Mailing address
410 W MAIN ST, OTTAWA, IL 61350-2802
(815) 434-7231
(815) 434-3549

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036059742
IL

Other

Enumeration date
05/27/2008
Last updated
12/15/2008
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