Provider Demographics
NPI:1902897002
Name:HWANG, MING H (MD)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:H
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 WALDEN LN
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-3734
Mailing Address - Country:US
Mailing Address - Phone:630-963-7669
Mailing Address - Fax:630-963-7994
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2333
Practice Address - Country:US
Practice Address - Phone:312-567-2380
Practice Address - Fax:312-328-7739
Is Sole Proprietor?:No
Enumeration Date:2005-10-29
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036049222207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036049222Medicaid
IL475460OtherPROVIDER NUMBER
IL036049222Medicaid
IL475460OtherPROVIDER NUMBER