Individual provider Active NPI

Miyoung Won, MD

  • General Practice Physician
  • Blue Island, IL
National Provider Identifier
1023072378
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036112910 Issued in IL
Practice address
2320 High St
Blue Island, IL 60406-2426
Phone
(708) 388-5500
Fax
(708) 388-5672
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036112910 IL
General Practice Physician 208D00000X 036112910 IL Primary

Addresses

Primary practice location

2320 High St
Blue Island, IL 60406-2426

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-9200

Other identifiers 2

IdentifierTypeStateIssuer
036112910MedicaidIL
P00271315OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060116000335 IL Practitioner - Obstetrics/Gynecology 4082638259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10137 Grand Ave
Franklin Park, IL 60131-2548
Phone (847) 451-7590

3145 S Ashland Ave
Suite 110
Chicago, IL 60608-6248
Phone (773) 254-5516

544 W Dundee Rd
Wheeling, IL 60090-2675
Phone (847) 419-6974

6500 W 65TH St
Chicago, IL 60638-4962
Phone (708) 496-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Illinois PC CurrentSince Nov 7, 2022 Accepting new patients

Locations

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1023072378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 HIGH ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062426",
            "telephone_number": "708-388-5500",
            "fax_number": "708-388-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WON",
        "first_name": "MIYOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036112910",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036112910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112910",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00271315",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

Verify at the official NPI Registry.