MEDICARE: DR. HILARY NAI-KWONG CHENG D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19-16377	IL

General Provider Information

NPI Number	:	1063677292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HILARY NAI-KWONG CHENG D.D.S.

Provider Business Mailing Address
First Line	:	6300 KINGERY HWY. STE 416,
Second Line	:	BOX 138,
City	:	WILLOWBROOK
State	:	IL
Zip	:	60527
Country	:	US
Telephone Number	:	312-791-1829
Fax Number	:	312-791-1819

Provider Business Practice Location Address
First Line	:	2165A S CHINA PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1536
Country	:	US
Telephone Number	:	312-791-1829
Fax Number	:	312-791-1819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	07/28/2008

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