MEDICARE: DENNIS HONG

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	207RP1001X	Pulmonary Disease Physician	036-079412	IL
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036079412	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	950150057	OTHER	IL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285730606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS HONG

Provider Business Mailing Address
First Line	:	2525 S MICHIGAN AVE
Second Line	:	ATT: MEDICAL STAFF OFFICE
City	:	CHICAGO
State	:	IL
Zip	:	60616-2315
Country	:	US
Telephone Number	:	312-567-7924
Fax Number	:	312-567-6189

Provider Business Practice Location Address
First Line	:	2525 S MICHIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-2315
Country	:	US
Telephone Number	:	312-567-5564
Fax Number	:	312-328-7819

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	05/21/2022

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Directions to “ DENNIS HONG ” Practice Location

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