Provider Demographics
NPI:1801384029
Name:KWON, CHASE W (MD)
Entity type:Individual
Prefix:DR
First Name:CHASE
Middle Name:W
Last Name:KWON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 N YORK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3515
Mailing Address - Country:US
Mailing Address - Phone:312-319-1978
Mailing Address - Fax:
Practice Address - Street 1:920 N YORK RD STE 100
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3515
Practice Address - Country:US
Practice Address - Phone:312-319-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.173296207N00000X
VA0101274667207N00000X
OH35.148134207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology