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General NPI Number Information
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NPI Number | 1265712731
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Entity Type | Individual
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Provider Name | KYUNGWON GLORIA YOON
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Gender | Female
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Dates
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Enumeration Date | 08/27/2011
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Last Update Date | 08/27/2011
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Provider Practice Location Address
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Address Line | 780 WAUKEGAN RD
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City | DEERFIELD
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State | IL
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Zip | 60015-4305
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Country | US
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Telephone | 847-945-0611
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Fax | 847-945-5978
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Provider Business Mailing Address
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Address Line | 2819 WILDFLOWER CT 780 WAUKEGAN RD DEERFIELD, IL 60015
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City | GLENVIEW
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State | IL
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Zip | 60026-1097
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051289857
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License Number State | IL
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