Individual provider Active NPI

Ok Ro Hong, MD

  • Psychiatry Physician
  • Park Ridge, IL
National Provider Identifier
1497711873
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-073905 Issued in IL
Practice address
2604 Dempster St
Suite 307
Park Ridge, IL 60068-8412
Phone
(847) 544-5102
Fax
(847) 544-5103
NPI assigned
Apr 25, 2006
Last updated
Jul 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-073905 IL Primary

Addresses

Primary practice location

2604 Dempster St
Suite 307
Park Ridge, IL 60068-8412

Mailing address

2604 Dempster St
Suite 307
Park Ridge, IL 60068-8412
Phone (847) 544-5102

Other identifiers 2

IdentifierTypeStateIssuer
036073905MedicaidIL
01632426OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000105 IL Practitioner - PsychiatryPractitioner - Addiction Medicine 0345212262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2604 Dempster St
Park Ridge, IL 60068-8427

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-073905ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Psych Associates SC Psychiatry CurrentSince Jun 1, 2002 Accepting new patients

Locations

2604 W Dempster St
Ste 307
Park Ridge, IL 60068
Phone (847) 299-9742

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1497711873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 307",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-544-5102",
            "fax_number": "847-544-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 307",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-544-5102",
            "fax_number": "847-544-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "OK",
        "middle_name": "RO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-073905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073905",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01632426",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.