IL S KWAK MD INC


Address: 2222 Timberbrook Trl, Fort Wayne, IN 46845-9530
Phone: 2606373939

IL S KWAK MD INC (NPI# 1134318447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134318447
Entity Type Organization
Organization Name IL S KWAK MD INC
Practice Address 2222 Timberbrook Trl
Fort Wayne
IN 46845-9530
Mailing Address 2222 Timberbrook Trl
Fort Wayne
IN 46845
Practice Telephone 2606373939
Practice Fax Number 2606373939
Mailing Telephone 2606373939
Mailing Fax Number 2606373939
Enumeration Date 2007-10-23
Last Update Date 2010-07-08
Authorized Official Name DR. IL S KWAK (PRESIDENT)
Authorized Official Telephone 2606373939
Authorized Official Credential M.D
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174400000X Specialist 01026132A IN Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 100054590A 05

Office Location

Street Address 2222 TIMBERBROOK TRL
City FORT WAYNE
State IN
Zip Code 46845-9530

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497788848 Il-sung Kwak Anesthesiology 2222 Timberbrook Trl, Fort Wayne, IN 46845-9530 2006-07-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881154110 Nancy Jean Ehmke Clinical Nurse Specialist 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 2019-03-22
1043703903 Kara Stackhouse Nurse Practitioner 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 2018-06-14
1871082412 Tara K Jellison Pharmacist 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 2018-05-09
1578097572 Forefront Dermatology, S.c. Dermatology 4020 New Vision Drive, Fort Wayne, IN 46845 2017-04-17
1811437999 Jessica Ann Lefever Behavioral Analyst 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 2017-03-08
1033668041 Bhi Home Care, Inc. In Home Supportive Care 820 Mill Lake Road, Fort Wayne, IN 46845 2016-10-03
1467814939 Austin Wyss Specialist/Technologist 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 2016-03-24
1154713584 Ashley Whitcraft Specialist/Technologist 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 2015-02-23
1275975682 Lakshmi Mohan Viji Das Internal Medicine 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 2013-07-26
1336482496 Mithun Mohana Shenoi Colon & Rectal Surgery 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 2013-03-27
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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679078398 Wright Choice Hairquarters Specialist 1815 Fox Point Trl Apt 2, Fort Wayne, IN 46816-2450 2018-03-26
1225581945 Hossam Eldine Kamal Youssef Specialist 7230 Engle Rd Ste 303, Fort Wayne, IN 46804-2227 2016-07-28
1245600972 Pediatric Cardiology Associates Specialist 5107 N Bend Dr, Fort Wayne, IN 46804-1753 2015-10-07
1598168197 Melinda Elise Smith Specialist 5812 Maplecrest Rd, Fort Wayne, IN 46835-3840 2014-09-27
1881000222 Denise Sparks Specialist 6415 Benham Drive, Fort Wayne, IN 46815 2014-07-07
1790076453 Susan Anne Walstra Specialist 4601 Heatherwind Dr, Apt. D, Fort Wayne, IN 46815-7135 2011-04-28
1265755250 William A Argus Md PC Specialist 7030 Pointe Inverness Way Ste 240, Fort Wayne, IN 46804-7925 2010-03-05
1033376413 A Step Ahead Therapies, LLC Specialist 6013 Belle Isle Ln, Fort Wayne, IN 46835-1263 2008-05-21
1932370590 Kerri Jo Trentacosti Specialist 5939 Brighton Meadows Dr, Apt. C, Fort Wayne, IN 46804-7664 2008-03-21
1649458662 Bernice Wilson Specialist 4202 Buell Dr, Fort Wayne, IN 46807-2743 2008-01-31
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Competitor

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City FORT WAYNE
Zip Code 46845

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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