Mrs Gina K Song, MD | |
2455 Dean St, Suite A, St Charles, IL 60175-4830 | |
(630) 513-9160 | |
(630) 513-9617 |
Full Name | Mrs Gina K Song |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2455 Dean St, St Charles, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386642445 | NPI | - | NPPES |
4532123 | Other | IL | BCBS |
036104024 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036104024 (Illinois) | Primary |
Entity Name | Central Dupage Physician Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033149844 PECOS PAC ID: 5890696231 Enrollment ID: O20040303000601 |
Mailing Address | Practice Location Address |
---|---|
Mrs Gina K Song, MD 2455 Dean St, Suite A, St Charles, IL 60175 Ph: (630) 513-9160 | Mrs Gina K Song, MD 2455 Dean St, Suite A, St Charles, IL 60175-4830 Ph: (630) 513-9160 |
Dr. Janet V Wildman, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 970 N 5th Ave, St Charles, IL 60174 Phone: 630-584-1950 Fax: 630-584-8994 | |
Nilam Bhikhabhai Patel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3310 W Main St Ste 200, St Charles, IL 60175 Phone: 630-897-6044 Fax: 630-659-3425 | |
Dr. Ma Luciana Holgado-cocjin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3310 W Main St, Suite 200, St Charles, IL 60175 Phone: 630-897-6044 Fax: 630-897-0180 | |
Dr. Withman H Haro, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3310 W Main St, Suite 200, St Charles, IL 60175 Phone: 630-897-6044 Fax: 630-897-0180 | |
John Howard Perryman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 215 S. 4th Ave, St Charles, IL 60174 Phone: 630-584-2340 Fax: 630-584-2825 | |
Dr. Hina Siddiqui, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 3755 E Main St Ste 190, St Charles, IL 60174 Phone: 630-348-3100 Fax: 630-513-0727 | |
Dr. Sarah Elizabeth Smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3310 W Main St, Suite 200, St Charles, IL 60175 Phone: 630-897-6044 Fax: 630-897-0180 |