Sung-Tao Ko, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036-045253 Issued in IL

Practice address

130 S Main St Ste 306
Lombard, IL 60148-2670

Phone

(630) 620-6040

Fax

(630) 620-6143

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811096936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST STE 306",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482670",
            "telephone_number": "630-620-6040",
            "fax_number": "630-620-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST STE 306",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482670",
            "telephone_number": "630-620-6040",
            "fax_number": "630-620-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "SUNG-TAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-045253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0002215295",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-045253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenny L Knapp, LCPC
• Joy Warner Knipmeyer, M.D.
• Jolene Knudson
• Cori Knutson, APN
• Ko Surgical Associates P.C
• Jay Gerald Kolb, DDS
• Robert Vincent Kolbusz, M.D.
• John Komperda
• Konrad Kordylasinski, M.S., BCBA
• Yuri Korvatko, DC

• Surgery Physician in Lombard, IL
• Providers in Lombard, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.