=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992842801
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TONY TSENG M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2007
-----------------------------------------------------
Last Update Date | 06/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10400 HALIGUS RD
-----------------------------------------------------
City | HUNTLEY
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60142-9553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-654-0000
-----------------------------------------------------
Fax | 224-654-0000
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12710 N GEORGETOWNE RD
-----------------------------------------------------
City | DUNLAP
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61525-9462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-390-3873
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 036151342
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | MD430589
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 37480
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | MD-55227
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------