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NPI Code Detail

MEDICARE: MR. KWAN CHONG M.DIV.

MEDICARE:  MR. KWAN  CHONG  M.DIV.
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
1171100000XAcupuncturist198.000121IL

Other Identifiers

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

General Provider Information

NPI Number : 1881964609
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KWAN CHONG M.DIV.
Provider Business Mailing Address
First Line : 342 E GOLF RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-4008
Country : US
Telephone Number : 847-702-3799
Fax Number :
Provider Business Practice Location Address
First Line : 342 E GOLF RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-4008
Country : US
Telephone Number : 847-702-3799
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2012
Last Update Date : 01/10/2012

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Directions to “ MR. KWAN CHONG M.DIV.” Practice Location

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