Provider Demographics
NPI:1962664540
Name:KAO, CHENG-KAI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHENG-KAI
Middle Name:
Last Name:KAO
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 1:5841 S MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1447
Mailing Address - Country:US
Mailing Address - Phone:773-834-8129
Mailing Address - Fax:773-795-7398
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:MC-5000, W314
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-834-8129
Practice Address - Fax:773-795-7398
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192965390200000X
IL036128026208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program