Provider Demographics
NPI:1356534911
Name:TANG, JAMES TIONG
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:TIONG
Last Name:TANG
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:TIONG
Other - Middle Name:LUK
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1585 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7768
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 W WACKER DR
Practice Address - Street 2:SUITE 820
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1216
Practice Address - Country:US
Practice Address - Phone:312-640-0329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL70009449OtherLICENSE#