Active NPI
Lionel B Wong, M.D.
- Gastroenterology Physician
- Dixon, IL
National Provider Identifier
1619945037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Practice address
- 215 E 1St St
Ste 211
Dixon, IL 61021-3166 - Phone
- (815) 285-5843
- Fax
- (815) 285-5846
- NPI assigned
- Mar 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | IL | Primary |
Addresses
Primary practice location
215 E 1St St
Ste 211
Dixon, IL 61021-3166
Mailing address
215 E 1St St
Ste 211
Dixon, IL 61021-3166
Phone (815) 285-5843
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036-083793 | IL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KSB Medical Group, Inc. | Gastroenterology | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1619945037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 E 1ST ST",
"address_2": "STE 211",
"city": "DIXON",
"state": "IL",
"postal_code": "610213166",
"telephone_number": "815-285-5843",
"fax_number": "815-285-5846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E 1ST ST",
"address_2": "STE 211",
"city": "DIXON",
"state": "IL",
"postal_code": "610213166",
"telephone_number": "815-285-5843",
"fax_number": "815-285-5846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "LIONEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dixon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.