MEDICARE: FAMILY PHYSICIANS INC

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
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1679001069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PHYSICIANS INC

Provider Business Mailing Address
First Line	:	5901 N CICERO AVE STE 600
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5721
Country	:	US
Telephone Number	:	773-983-6204
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 N CICERO AVE STE 600
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5721
Country	:	US
Telephone Number	:	773-983-6204
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	YONGSOO KWON
Credential	:	MD
Telephone Number	:	773-983-6204

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	07/21/2022

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