Provider Demographics
NPI:1659346161
Name:TANG, MING-YENG SU (MD)
Entity type:Individual
Prefix:DR
First Name:MING-YENG
Middle Name:SU
Last Name:TANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3615
Mailing Address - Country:US
Mailing Address - Phone:708-424-2082
Mailing Address - Fax:708-576-8476
Practice Address - Street 1:9710 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3615
Practice Address - Country:US
Practice Address - Phone:708-424-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-18
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-077656207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-077656Medicaid
F01437Medicare UPIN