Active NPI
Hong Cao, MD
- Psychiatry Physician
- Kankakee, IL
National Provider Identifier
1669601712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 54673
- Practice address
- 500 N Wall St Ste 200
Kankakee, IL 60901-2942 - Phone
- (815) 937-1237
- Fax
- (815) 933-0662
- NPI assigned
- Jul 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 125-057218 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 54673 | MN | Primary |
| Psychiatry Physician | 2084P0800X | 036133201 | IL |
Addresses
Primary practice location
500 N Wall St Ste 200
Kankakee, IL 60901-2942
Mailing address
500 N Wall St Ste 200
Kankakee, IL 60901-2942
Phone (815) 937-1237
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | MN |
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 |
|---|---|---|---|
| 125-057218 | IL | MD | Psychiatry Physician |
| 54673 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1669601712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N WALL ST STE 200",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012942",
"telephone_number": "815-937-1237",
"fax_number": "815-933-0662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N WALL ST STE 200",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012942",
"telephone_number": "815-937-1237",
"fax_number": "815-933-0662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAO",
"first_name": "HONG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-10",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "125-057218",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "54673",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036133201",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.