MEDICARE: ADINA GONG

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	224Z00000X	Occupational Therapy Assistant	010099	NY
2	224Z00000X	Occupational Therapy Assistant	057.005748	IL
3	225X00000X	Occupational Therapist	028812	NY
4	225X00000X	Occupational Therapist	056.015879	IL

General Provider Information

NPI Number	:	1972145209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADINA GONG

Provider Business Mailing Address
First Line	:	9332 LANDINGS LN UNIT 601
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-5247
Country	:	US
Telephone Number	:	347-702-2888
Fax Number	:

Provider Business Practice Location Address
First Line	:	9332 LANDINGS LN UNIT 601
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-5247
Country	:	US
Telephone Number	:	347-702-2888
Fax Number	:

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

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	05/09/2025

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Directions to “ ADINA GONG ” Practice Location

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