Provider Demographics
NPI:1679280747
Name:KWON, PHILIP SOON WOO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:SOON WOO
Last Name:KWON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1011
Mailing Address - Country:US
Mailing Address - Phone:847-338-5148
Mailing Address - Fax:
Practice Address - Street 1:1489 PALATINE RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-1196
Practice Address - Country:US
Practice Address - Phone:847-202-9232
Practice Address - Fax:847-202-1227
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.305203183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist