Active NPI
Nathan Kong
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1962877456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125.073560
- Practice address
- 5841 S Maryland Ave Ste Mc7082
Chicago, IL 60637-1465 - Phone
- (773) 702-6840
- NPI assigned
- Dec 9, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 125.073560 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave Ste Mc7082
Chicago, IL 60637-1465
Mailing address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150
Other practice location 1
240 E Huron St
Suite 1-200
Chicago, IL 60611-2909
Phone (312) 503-7975
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 |
|---|---|---|---|
| 125.073560 | IL | MD | Internal Medicine Physician |
Interoperability endpoints
- nkong179802@uchospital.direct-ci.com
- nkong253327@direct.bilh.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1962877456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 HARVESTER DR STE 110",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276686",
"telephone_number": "773-702-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE STE MC7082",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371465",
"telephone_number": "773-702-6840"
}
],
"practiceLocations": [
{
"address_1": "240 E Huron St",
"address_2": "Suite 1-200",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112909",
"country_code": "US",
"telephone_number": "312-503-7975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KONG",
"first_name": "NATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-09",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.073560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.