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1871853259
PONG MEDICAL CENTER LLC
CHICAGO, IL
NPI
1871853259
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Entity Type
Organization
Authorized Contact
SUCHAT PONGLORPISITA
Md
773-218-9625
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036048043)
Enumeration Date
2012-05-20
Last Update Date
2016-05-24
Business Address
PONG MEDICAL CENTER LLC
5151 N LINCOLN AVE
CHICAGO, IL 60625-2520
Phone number: 773-784-0900
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Mailing Address
PONG MEDICAL CENTER LLC
11110 MARTINDALE DR
WESTCHESTER, IL 60154-4920
Phone number: 773-218-9625
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