Benchuan Gong, M.D. (CHINA)

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

198001152 Issued in IL

Practice address

4921 N Kimball Ave
Chicago, IL 60625-5110

Phone

(773) 583-2142

NPI assigned

Oct 16, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1407284177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 N KIMBALL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606255110",
            "telephone_number": "773-583-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 N KIMBALL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606255110",
            "telephone_number": "773-583-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "BENCHUAN",
        "name_prefix": "Dr.",
        "credential": "M.D. (CHINA)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198001152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Caitlin Gondek, APN
• Srikara Dheeraj Reddy Gondhi, MBBS
• Daniel Gondi, MD
• Harsha Canan Gondi, MD
• Stephanie Gondra-Sanabria, MD
• Debra A Gong, D.D.S.
• Edward Ming-Luan Gong, M.D.
• Fei Fei Gong, MD
• Jennifer H Gong
• Kenneth Hong Gong, MD

• Acupuncturist in Chicago, IL
• Providers in Chicago, IL by specialty
• Acupuncturist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.