Sang Jo Han, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036061812 Issued in IL

Practice address

473 W Army Trail Road
# 102
Bloomingdale, IL 60108

Phone

(630) 529-6969

Fax

(630) 529-7497

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• All Bear Cub Pediatrics, S.C.

  • Pediatrics Physician
  • Bloomingdale, IL
  • NPI 1174681555
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043396310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 W ARMY TRAIL ROAD",
            "address_2": "# 102",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "630-529-6969",
            "fax_number": "630-529-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 W ARMY TRAIL ROAD",
            "address_2": "# 102",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "630-529-6969",
            "fax_number": "630-529-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "SANG",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036061812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061812",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Christine Hagen-Sprovieri, M.ED.
• Kailyn Hagerty
• Amina Haider, OD
• Seema Hameed
• Carlene Mary Hamrin, L.C.P.C.
• William Dennis Hancock Jr., DDS
• Dianna Hanna
• Faraz Imtiaz Haque, DPM
• Lori L Hardy, M.D.
• Aimee Harris-Newon, PSY D.

• Pediatrics Physician in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.