Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036128593 | IL |
N | 208000000X | Pediatrician | 48943 | MN |
NPI | 1174624241 |
---|---|
Provider Name | Amiinah Y Kung |
First Address | Naperville, IL 60564-9361 |
Second Address | Naperville, IL 60564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 12/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I61185 | (02) |