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General NPI Number Information
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NPI Number | 1376974394
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Entity Type | Organization
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Legal Business Name | WHEELWALKING SC
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Dates
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Enumeration Date | 12/01/2013
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 1510 GLENWOOD AVE
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City | GLENVIEW
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State | IL
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Zip | 60025-2142
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Country | US
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Telephone | 847-729-0403
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Fax |
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Provider Business Mailing Address
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Address Line | 1510 GLENWOOD AVE
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City | GLENVIEW
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State | IL
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Zip | 60025-2142
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Country | US
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Telephone | 847-729-0403
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SEONG CHIN
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Credential |
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Telephone | 847-729-0403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036112303
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License Number State | IL
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