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General NPI Number Information
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NPI Number | 1770910556
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Entity Type | Organization
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Legal Business Name | KOREAN-AMERICAN COMMUNITY SERVICES
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 664 N MILWAUKEE AVE SUITE 209
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City | PROSPECT HEIGHTS
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State | IL
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Zip | 60070-2300
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Country | US
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Telephone | 847-520-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60618-1514
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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 | EXECUTIVE DIRECTOR
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Name | INCHUL CHOI
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Credential |
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Telephone | 17735835501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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