Individual
DR. JAMES GIN MO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 N MAGNOLIA, SUITE D, CHICAGO, IL 60640-4965
(773) 989-1885
(773) 989-9828
Mailing address
4600 N MAGNOLIA, SUITE D, CHICAGO, IL 60640-4965
(773) 989-1885
(773) 989-9828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036094035
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094035
—
IL
01
—
L98992
PTAN
IL
Enumeration date
12/06/2005
Last updated
09/14/2021
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