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1386404499
JACOB SAMSON FANG
CHICAGO, IL
NPI
1386404499
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-19
Last Update Date
2024-03-19
Business Address
JACOB SAMSON FANG MD
2900 N LAKE SHORE DR
CHICAGO, IL 60657-5640
Phone number: 773-665-3000
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Mailing Address
JACOB SAMSON FANG MD
1920 E HUBBARD AVE
SALT LAKE CITY, UT 84108-1304
Phone number: 801-703-0334
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