Southwest Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036059742 Issued in IL

Legal business name

SOUTHWEST DERMATOLOGY

Practice address

410 W Main St
Ottawa, IL 61350-2802

Phone

(815) 434-7231

Fax

(815) 434-3549

NPI assigned

May 27, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Cheuk W Yung, M.D.

Title

President

Phone

(815) 434-7231

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1770741860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W MAIN ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502802",
            "telephone_number": "815-434-7231",
            "fax_number": "815-434-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W MAIN ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502802",
            "telephone_number": "815-434-7231",
            "fax_number": "815-434-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "YUNG",
        "authorized_official_first_name": "CHEUK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-434-7231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036059742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Ottawa, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.