Dr. Jayme Kwak, M.D.
Internal Medicine in Pontiac, IL. Individual provider (NPI-1).
NPI number1750776233
StatusActive
Last updated in NPPESJun 28, 2019
Details
- NPI
- 1750776233
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jayme Kwak
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 1, 2015
- Last updated
- Jun 28, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 036.149594 | IL | Yes |
| 208000000X | Pediatrics | 036.149594 | IL |
Practice location
2500 W Reynolds StPontiac, IL 61764-9774
Phone 815-842-2828
Mailing address
2500 W Reynolds StPontiac, IL 61764-9774
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