Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 125077279 | IL |
NPI | 1215462361 |
---|---|
Provider Name | Daniel Chun-Suk Oh |
First Address | Chicago, IL 60611-0010 |
Second Address | Chicago, IL 60611-3907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2017 |
Last Update Date | 09/06/2021 |