Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 036.136519 | IL |
N | 207RX0202X | Medical Oncology | ME92099 | FL |
NPI | 1093911307 |
---|---|
Provider Name | Dr. Eugene R. Ahn |
First Address | Zion, IL 60099 |
Second Address | Chicago, IL 60674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2007 |
Last Update Date | 26/10/2016 |