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General NPI Number Information
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NPI Number | 1245869718
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Entity Type | Individual
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Provider Name | CHRISTOPHER HAANSEHM KANG DO
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Gender | Male
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1875 W DEMPSTER ST
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City | PARK RIDGE
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State | IL
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Zip | 60068-1186
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Country | US
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Telephone | 477-955-8658
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5010
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City | MINOT
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State | ND
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Zip | 58702-5010
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Country | US
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Telephone | 701-418-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | PT22936
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 125.077078
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License Number State | IL
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