Individual
DR. SUNG-TAO KO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 S MAIN ST STE 306, LOMBARD, IL 60148-2670
(630) 620-6040
(630) 620-6143
Mailing address
130 S MAIN ST STE 306, LOMBARD, IL 60148-2670
(630) 620-6040
(630) 620-6143
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-045253
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002215295
BLUE CROSS
IL
05
—
036-045253
—
IL
Enumeration date
09/22/2006
Last updated
07/08/2007
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