Individual
BOB KAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1635 N WINCHESTER AVE, CHICAGO, IL 60622-1321
(773) 276-5886
Mailing address
1635 N WINCHESTER AVE, CHICAGO, IL 60622-1321
(773) 276-5886
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036094799
IL
2085R0204X
Vascular & Interventional Radiology Physician
036094799
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094799
—
IL
Enumeration date
08/10/2006
Last updated
01/29/2023
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