Individual provider Active NPI

Julian H Tang, M.D.

  • Pediatrics Physician
  • Naperville, IL
National Provider Identifier
1548233638
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036128594 Issued in IL
Practice address
636 Raymond Dr
Suite 205
Naperville, IL 60563-9789
Phone
(630) 717-2300
Fax
(630) 717-9638
NPI assigned
Feb 9, 2006
Last updated
Oct 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X A104067 CA
Pediatrics Physician 208000000X 47798 MN
Pediatrics Physician 208000000X 036128594 IL Primary

Addresses

Primary practice location

636 Raymond Dr
Suite 205
Naperville, IL 60563-9789

Mailing address

636 Raymond Dr
Suite 205
Naperville, IL 60563-9789
Phone (630) 717-2300

Other identifiers 1

IdentifierTypeStateIssuer
036128594MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036128594ILMDPediatrics Physician
47798MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children's Hospital of Chicago Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jtang251833@direct.luriechildrens.org
  • Direct secure messaging: juliantang@pha.allscriptsdirect.net

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1548233638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "JULIAN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A104067",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "47798",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036128594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036128594",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.