NPI 1134318447

Il S Kwak MD INC

Organisation Specialist Fort Wayne, IN

Practice location

Address: 2222 Timberbrook Trl, Fort Wayne, IN 46845-9530
Phone: (260) 637-3939
Fax: (260) 637-3939
Mailing address: 2222 Timberbrook Trl, Fort Wayne, IN 46845

Authorised official

Name: Il S Kwak
Title: President
Phone: (260) 637-3939

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 01026132A (IN)

Other Specialist providers in Indiana →

Registry record

NPI: 1134318447
Entity type: Organization
NPI issued: 23 Oct 2007
Record last updated: 8 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.