Provider Demographics
NPI:1710583307
Name:MODERN ENT AND FACE SC
Entity Type:Organization
Organization Name:MODERN ENT AND FACE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEHJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-877-5522
Mailing Address - Street 1:980 N MICHIGAN AVE STE 1100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4529
Mailing Address - Country:US
Mailing Address - Phone:312-877-5522
Mailing Address - Fax:312-877-5521
Practice Address - Street 1:980 N MICHIGAN AVE STE 1100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4529
Practice Address - Country:US
Practice Address - Phone:312-877-5522
Practice Address - Fax:312-877-5521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty