| NPI | 1417363813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH YOON CHANG President 219-488-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2019-09-19 |