Individual provider Active NPI

Hwan G Jeong, M.D.

  • Hematology & Oncology Physician
  • Normal, IL
National Provider Identifier
1366440604
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036080093 Issued in IL
Practice address
1606 Hunt Dr
Normal, IL 61761-2192
Phone
(309) 452-9701
Fax
(309) 454-1957
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036080093 IL Primary

Addresses

Primary practice location

1606 Hunt Dr
Normal, IL 61761-2192

Mailing address

1606 Hunt Dr
Normal, IL 61761-2192
Phone (309) 452-9701

Other identifiers 1

IdentifierTypeStateIssuer
036080093MedicaidIL

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
I20090105000175 IL Practitioner - Hematology/Oncology 3274695044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Illinois Hematology Oncology Associates LTDGroup PAC ID 7618039470, 4 clinicians

Practice addresses (Care Compare)

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

1606 Hunt Dr
Normal, IL 61761-2192
Phone (309) 452-9701

Hospital & facility affiliations

  • Saint James Hospital Hospital, Pontiac, IL, CCN 140161
  • Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Illinois Hematology Oncology Associates LTD Hematology & Oncology CurrentSince Jan 1, 1987 Accepting new patients
Christie Clinic, PLLC Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

422 W White St
Clinton, IL 61727
Phone (217) 935-9570

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

1606 Hunt Dr
Normal, IL 61761
Phone (309) 451-8888

407 E Vernon Ave
Ste 104
Normal, IL 61761
Phone (309) 287-7539

608 N Ladd St
Pontiac, IL 61764
Phone (815) 842-4584

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1366440604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 HUNT DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612192",
            "telephone_number": "309-452-9701",
            "fax_number": "309-454-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 HUNT DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612192",
            "telephone_number": "309-452-9701",
            "fax_number": "309-454-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "HWAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036080093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080093",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.