Provider Demographics
NPI:1093911307
Name:AHN, EUGENE R (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:R
Last Name:AHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 ELISHA AVE
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099
Mailing Address - Country:US
Mailing Address - Phone:847-872-4561
Mailing Address - Fax:847-731-1017
Practice Address - Street 1:2361 PAYSPHERE CIR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60674
Practice Address - Country:US
Practice Address - Phone:847-746-4358
Practice Address - Fax:847-731-1017
Is Sole Proprietor?:No
Enumeration Date:2007-06-23
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92099207RX0202X
IL036.136519207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology