Stephen Bryan Ogwang
Family Medicine in Chicago, IL. Individual provider (NPI-1).
NPI number1164091153
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1164091153
- Entity type
- Individual (NPI-1)
- Name
- Stephen Bryan Ogwang
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2021
- Certification date
- Jun 23, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 125079000 | IL | Yes |
Practice location
1901 W Harrison StChicago, IL 60612-3714
Phone 312-864-6000
Mailing address
1901 W Harrison StChicago, IL 60612-3714
Phone 312-864-6000
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