Provider Demographics
NPI:1275085003
Name:HONG, SEUL ONG (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:SEUL
Middle Name:ONG
Last Name:HONG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 JOHNSON DR
Mailing Address - Street 2:APT 3014
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6567
Mailing Address - Country:US
Mailing Address - Phone:847-287-3978
Mailing Address - Fax:
Practice Address - Street 1:871 ILLINOIS ROUTE 83
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106
Practice Address - Country:US
Practice Address - Phone:888-806-3379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.299943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist