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NPI Code Detail

MEDICARE: DR. ANITA TANG ONG M.D.

MEDICARE: DR. ANITA TANG ONG M.D.
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
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1699828715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANITA TANG ONG M.D.
Provider Business Mailing Address
First Line : 46 WOODLAND DR
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1439
Country : US
Telephone Number : 630-782-5165
Fax Number :
Provider Business Practice Location Address
First Line : 405 HARRISON ST
Second Line :
City : OAK PARK
State : IL
Zip : 60304-1427
Country : US
Telephone Number : 708-848-9390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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