Healthcare Provider Details

I. General information

NPI: 1962152710
Provider Name (Legal Business Name): EPIC MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BIESTERFIELD RD STE 203
ELK GROVE VILLAGE IL
60007-7300
US

IV. Provider business mailing address

901 BIESTERFIELD RD STE 203
ELK GROVE VILLAGE IL
60007-7300
US

V. Phone/Fax

Practice location:
  • Phone: 773-495-6006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAVID KANG
Title or Position: OWNER
Credential: MD
Phone: 580-478-6347