Provider Demographics
NPI:1790885572
Name:TANG, IGNATIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:IGNATIUS
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:820 S WOOD ST # MC793
Mailing Address - Street 2:462 CSN
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-413-5732
Mailing Address - Fax:312-996-7378
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:DEPT 3462
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:312-704-2885
Practice Address - Fax:312-704-2737
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2014-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036110985207RN0300X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery