Ki Seok Won, MD
Internal Medicine in Evanston, IL. Individual provider (NPI-1).
NPI number1164048179
StatusActive
Last updated in NPPESMar 26, 2023
Details
- NPI
- 1164048179
- Entity type
- Individual (NPI-1)
- Name
- Ki Seok Won
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2020
- Certification date
- Mar 26, 2023
- Last updated
- Mar 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 01089065A | IN | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
355 Ridge AveEvanston, IL 60202-3328
Phone 847-316-4000
Mailing address
1620 Central St Apt 302Evanston, IL 60201-1599
Phone 224-307-0929
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