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NPI Code Detail

MEDICARE: ALBERT C SONG MD

MEDICARE: ALBERT C SONG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianIL

General Provider Information

NPI Number : 1083614762
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALBERT C SONG MD
Provider Business Mailing Address
First Line : PO BOX 2669
Second Line :
City : JOLIET
State : IL
Zip : 60434-2669
Country : US
Telephone Number : 815-726-6860
Fax Number :
Provider Business Practice Location Address
First Line : 333 MADISON ST
Second Line :
City : JOLIET
State : IL
Zip : 60435-8200
Country : US
Telephone Number : 815-725-7133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 07/08/2007

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