Individual provider Active NPI

Kenneth Hong Gong, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1851516660
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036106356 Issued in IL
Practice address
4600 N Ravenswood Ave
Chicago, IL 60640-4510
Phone
(773) 561-7500
Fax
(773) 561-7612
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 036106356 IL Primary

Addresses

Primary practice location

4600 N Ravenswood Ave
Chicago, IL 60640-4510

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kgong206395@direct.myadvocateaurora.org Direct

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
I20070807000792 IL Practitioner - Family Practice 0840381778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4600 N Ravenswood Ave
Chicago, IL 60640-4510
Phone (773) 561-7500

836 W Wellington
Suite G346
Chicago, IL 60657-5147
Phone (773) 296-7147

836 W Wellington Ave
Chicago, IL 60657-5147

Hospital & facility affiliations

  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036106356ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

4100 Healthway Dr
Aurora, IL 60504
Phone (630) 851-3105

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

1301 E 47th St
Chicago, IL 60653
Phone (773) 493-8212

75 Remittance Dr
Dept 6994
Chicago, IL 60675

75 Remittance Dr
Chicago, IL 60675

29373 Network Pl
Chicago, IL 60673

Interoperability endpoints

  • Direct secure messaging: kgong206395@direct.myadvocateaurora.org

Organizations & group practices 3

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1851516660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N RAVENSWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404510",
            "telephone_number": "773-561-7500",
            "fax_number": "773-561-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "KENNETH",
        "middle_name": "HONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036106356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4100 Healthway Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605044163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgong206395@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4100 Healthway Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605044163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.