Individual provider Active NPI

Quoc Tommy Dang, D.O.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1639539752
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.147714 Issued in IL
Practice address
4753 N Elston Ave
Chicago, IL 60630-4490
Phone
(773) 205-7200
Fax
(773) 481-7577
NPI assigned
Mar 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.147714 IL Primary

Addresses

Primary practice location

4753 N Elston Ave
Chicago, IL 60630-4490

Mailing address

5060 N Broadway St
Chicago, IL 60640-3007
Phone (773) 293-8890

Other practice location 1

5060 N Broadway St
Chicago, IL 60640-3007
Phone (773) 293-8890

Other names 1

  • Tommy Quoc Dang Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address qdang277182@direct.northshore.org
Direct Messaging Address qdang277182@direct.northshore.org

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
I20190725002821 IL Practitioner - Family Practice 6608102819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

5060 N Broadway St
Chicago, IL 60640-3007
Phone (773) 907-3038

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.147714ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 28, 2023 Accepting new patients
Swedish Covenant Management Services, Inc. Family Medicine CurrentSince Aug 15, 2019 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Jan 28, 2023 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Aug 15, 2019 Accepting new patients

Locations

5060 N Broadway St
Chicago, IL 60640
Phone (773) 293-4200

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2740 W Foster Ave
Ste 310
Chicago, IL 60625

4753 N Elston Ave
Chicago, IL 60630
Phone (773) 205-7200

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: qdang277182@direct.northshore.org

Organizations & group practices 4

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 2

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1639539752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403007",
            "telephone_number": "773-293-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304490",
            "telephone_number": "773-205-7200",
            "fax_number": "773-481-7577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5060 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606403007",
            "country_code": "US",
            "telephone_number": "773-293-8890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "QUOC",
        "middle_name": "TOMMY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.147714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "qdang277182@direct.northshore.org",
            "affiliation": "N",
            "address_1": "4753 N Elston Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606304490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "qdang277182@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5060 N Broadway St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606403007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TOMMY",
            "last_name": "DANG",
            "middle_name": "QUOC",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.