Provider Demographics
NPI:1154833473
Name:TONG, ROBYN (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:TONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E HURON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3858
Mailing Address - Country:US
Mailing Address - Phone:312-266-6240
Mailing Address - Fax:
Practice Address - Street 1:676 N SAINT CLAIR ST STE 1575
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2889
Practice Address - Country:US
Practice Address - Phone:312-266-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant