Individual provider Active NPI

Kwang M Jang, D.O.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1326271909
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036132637 Issued in IL
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, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
036132637OtherILIL PERMANENT LICENSE
125056216OtherILIL STATE LICENSE # 125056216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131001000421 IL Practitioner - Internal Medicine 6103069273 Reassigns benefits to 1 organization
I20161122001857 WI Practitioner - Internal Medicine 6103069273 Reassigns benefits to 2 organizations

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 NetworkGroup PAC ID 9537076112, shared by 36 NPIs, 182 clinicians

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

LicenseStateTypeSpecialty
036132637ILMDInternal Medicine Physician
125056216ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Aug 26, 2013 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Mar 7, 2017 Accepting new patients
Apogee Medical Group, Wisconsin, S.C Internal Medicine CurrentSince Jul 7, 2018 Accepting new patients
Access Community Health Network CurrentSince Aug 26, 2013 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.