Provider Demographics
NPI:1154680510
Name:HONG, JOHN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 HEATHERMOOR PARK DR. S.
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074
Mailing Address - Country:US
Mailing Address - Phone:317-522-6137
Mailing Address - Fax:
Practice Address - Street 1:8001 N LINCOLN AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3695
Practice Address - Country:US
Practice Address - Phone:847-588-7170
Practice Address - Fax:847-588-7060
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023435A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist