Il S Kwak Md Inc

LBN: Il S Kwak Md Inc
Il S Kwak Md Inc is an health care organization with primary practice located at 2222 Timberbrook Trl , Fort Wayne IN 46845-9530. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Il S Kwak Md Inc can be contacted via phone (260) 637-3939, or through Kwak, Il S via phone (260) 637-3939.

Contact Information

Primary practice address
2222 Timberbrook Trl Fort Wayne IN 46845-9530
Phone: (260) 637-3939
Fax: (260) 637-3939
Website:
Map and Directions
Authorized official contact:
Name: Kwak, Il S Doctor of Medicine (MD)
Phone: (260) 637-3939

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01026132A Indiana

Profile Details

NPI number 1134318447
LBN Legal business name Il S Kwak Md Inc
DBA Doing business as
Authorized official Kwak, Il S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 23rd, 2007
Last updated Jul 8th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134318447 NPPES
Indiana MEDICAID 100054590A

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