IL S KWAK MD INC NPI 1134318447

NPI Information

IL S KWAK MD INC is a specialist in Fort Wayne, IN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. IL S KWAK MD INC NPI is 1134318447. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2222 TIMBERBROOK TRL
FORT WAYNE, IN
ZIP 46845-530
Phone: (260) 637-3939
Fax: (260) 637-3939

The provider's authorized official is Il S Kwak .
The authorized official title is President and has the following contact phone number (260) 637-3939.

The enumeration date for this NPI number is 10/23/2007 and was last updated on 7/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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