Provider Demographics
NPI:1487677076
Name:HONG, DAVID T (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:HONG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 W WASHINGTON ST
Mailing Address - Street 2:SUITE 930
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2301
Mailing Address - Country:US
Mailing Address - Phone:312-263-2443
Mailing Address - Fax:312-263-0441
Practice Address - Street 1:180 W WASHINGTON ST
Practice Address - Street 2:SUITE 930
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3580
Practice Address - Country:US
Practice Address - Phone:312-263-2443
Practice Address - Fax:312-263-0441
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL016003687213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016003687Medicaid
IL60001532OtherBLUE CROSS BLUE SHIELD
IL730350Medicare ID - Type Unspecified
IL016003687Medicaid