Ko, Sung-Tao
Ko, Sung-Tao is an sole proprietor health care provider with primary practice located at 130 S Main St Ste 306 , Lombard IL 60148-2670. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Ko, Sung-Tao can be contacted via phone (630) 620-6040.Contact Information
Primary practice address
130 S Main St Ste 306
Lombard IL 60148-2670
Phone: (630) 620-6040
Fax: (630) 620-6143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036-045253 | Illinois |
Profile Details
| NPI number | 1811096936 |
|---|---|
| LBN Legal business name | Ko, Sung-Tao |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811096936 | NPPES |
| Illinois | Other | 0002215295 | BLUE CROSS |
| Illinois | MEDICAID | 036-045253 | BLUE CROSS |
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