Provider Demographics
NPI:1396846598
Name:DU, HONGKAI KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:HONGKAI
Middle Name:KEVIN
Last Name:DU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 24001
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-9001
Mailing Address - Country:US
Mailing Address - Phone:618-767-3814
Mailing Address - Fax:618-257-6671
Practice Address - Street 1:4700 MEMORIAL DRIVE, SUITE 230 (PAIN CENTER)
Practice Address - Street 2:4500 MEMORIAL DRIVE (MEMORIAL HOSPITAL)
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226
Practice Address - Country:US
Practice Address - Phone:618-257-5902
Practice Address - Fax:618-257-6671
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036111184207LP2900X
IL36111184207LP2900X, 208100000X, 2081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111184Medicaid
ILK06590Medicare ID - Type Unspecified