Kwakbear P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.120211 Issued in IL

Legal business name

KWAKBEAR P.C.

Practice address

5011 Carpenter Ave
Oswego, IL 60543-8027

Phone

(630) 636-7072

NPI assigned

Feb 23, 2009

Organization subpart

No

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

Authorized official

Name

Justin Kwak, M.D.

Title

President

Phone

(630) 636-7072

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1821238346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 CARPENTER AVE",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438027",
            "telephone_number": "630-636-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 CARPENTER AVE",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438027",
            "telephone_number": "630-636-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWAKBEAR P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "KWAK",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-636-7072",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.120211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Helen Kowalski, DPT
• Deborah Kozlowski, LCSW
• Erika L. Krouth, D.D.S.
• Jennifer L Kurka, D.O.
• Heather Kuttner, LCSW
• Maria Labova Burggraf
• Kamilla Laird, MOT OTRL
• Kelly Lally, DC
• Erica Lamb, L.S.W.
• Kelly Lamonica

• Pediatrics Physician in Oswego, IL
• Providers in Oswego, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.