Provider Demographics
NPI:1417904749
Name:JIANG, NING (MD)
Entity Type:Individual
Prefix:DR
First Name:NING
Middle Name:
Last Name:JIANG
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 1:5000 S 5TH AVE BLDG 128
Mailing Address - Street 2:
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141-3030
Mailing Address - Country:US
Mailing Address - Phone:708-202-2241
Mailing Address - Fax:708-202-7960
Practice Address - Street 1:5000 S 5TH AVE BLDG 128
Practice Address - Street 2:
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-3030
Practice Address - Country:US
Practice Address - Phone:708-202-2241
Practice Address - Fax:708-202-7960
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106621208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK14936Medicare ID - Type Unspecified
ILH56506Medicare UPIN
ILK18988Medicare ID - Type Unspecified