Provider Demographics
NPI:1134129281
Name:HORNG, MENG Y (MD)
Entity Type:Individual
Prefix:DR
First Name:MENG
Middle Name:Y
Last Name:HORNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N REGENCY DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3515
Mailing Address - Country:US
Mailing Address - Phone:309-663-9334
Mailing Address - Fax:
Practice Address - Street 1:107 N REGENCY DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3515
Practice Address - Country:US
Practice Address - Phone:309-663-9334
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILAH 6205000OtherDEA
IL275950Medicare ID - Type UnspecifiedPROVIDER #
ILD-10576Medicare UPIN