Southwest Dermatology

NPI #1770741860 in Ottawa, Illinois

Provider Information

NPI Number: 1770741860
Entity Type: Organization
Organization Name: Southwest Dermatology
Primary Specialty: Dermatology
Enumeration Date: May 27, 2008
Last Updated: Dec 15, 2008

Practice Location

Address: 410 W MAIN ST
City: Ottawa
State: Illinois
ZIP Code: 61350-2802
Phone: (815) 434-7231

Authorized Official

Name: DR. CHEUK W YUNG, M.D.
Title: PRESIDENT
Phone: (815) 434-7231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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