Healthcare Provider Details

I. General information

NPI: 1740784313
Provider Name (Legal Business Name): RENEE G CHENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 WEAVER PKWY
WARRENVILLE IL
60555-3269
US

IV. Provider business mailing address

3855 HEALTH SCIENCES DR # 829
LA JOLLA CA
92093-0829
US

V. Phone/Fax

Practice location:
  • Phone: 630-352-5450
  • Fax: 630-352-5499
Mailing address:
  • Phone: 858-657-5281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number174156
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036170540
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: