Active NPI
Kwang M Jang, D.O.
- Internal Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036132637
- Practice address
- 7464 N Clark St
Chicago, IL 60626-1620 - Phone
- (773) 381-8700
- Fax
- (773) 381-8701
- NPI assigned
- Aug 28, 2009
- Last updated
- Sep 25, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125056216 | IL | |
| Internal Medicine Physician | 207R00000X | 036132637 | IL | Primary |
Addresses
Primary practice location
7464 N Clark St
Chicago, IL 60626-1620
Mailing address
7464 N Clark St
Chicago, IL 60626-1620
Phone (773) 381-8700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036132637 | Other | IL | IL PERMANENT LICENSE |
| 125056216 | Other | IL | IL STATE LICENSE # 125056216 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Community Health Network
Practice addresses (Care Compare)
1 N Broadway St
Des Plaines, IL 60016-2335
Phone (847) 298-3150
1723 Howard St
Evanston, IL 60202-3735
Phone (224) 307-8550
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036132637 | IL | MD | Internal Medicine Physician |
| 125056216 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current | Accepting new patients | |
| Ascension Medical Group-Southeast Wisconsin Inc | Internal Medicine | Current | Accepting new patients |
| Apogee Medical Group, Wisconsin, S.C | Internal Medicine | Current | Accepting new patients |
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Past | Accepting new patients | |
| Prohealth Medical Group Inc | Internal Medicine | Past | Accepting new patients |
Locations
15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601
7464 N Clark St
Chicago, IL 60626
Phone (773) 381-8700
1 N Broadway St
Des Plaines, IL 60016
Phone (847) 298-3150
1723 Howard St
Evanston, IL 60202
Phone (224) 307-8550
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
3811 Spring St
Ste 203
Mount Pleasant, WI 53405
Phone (262) 687-8677
125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
725 American Ave
Rm 2036
Waukesha, WI 53188
Phone (262) 928-1000
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Interoperability endpoints
- kjang6384@direct.achn.net
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
dba Ascension Medical Group
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1275605792
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1043398217
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Advocate Lutheran General Hospital
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
-
dba Endeavor Health Evanston Hospital
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
-
dba Endeavor Health Northwest Community Hospital
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1578932869
-
dba Endeavor Health Northwest Community Hospital
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1770531600
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1982442398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1326271909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7464 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606261620",
"telephone_number": "773-381-8700",
"fax_number": "773-381-8701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7464 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606261620",
"telephone_number": "773-381-8700",
"fax_number": "773-381-8701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANG",
"first_name": "KWANG",
"middle_name": "M",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-28",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125056216",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036132637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL PERMANENT LICENSE",
"identifier": "036132637",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL STATE LICENSE # 125056216",
"identifier": "125056216",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.