Individual
DR. CHENG H LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 9TH ST STE 200, ROCKFORD, IL 61104-2235
(779) 696-8799
(779) 696-3352
Mailing address
P.O. BOX 1559, STONY BROOK, NY 11790
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
036170580
IL
2086S0129X
Vascular Surgery Physician
232236
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02574005
—
NY
01
—
1N0241
EMPIRE BC.BS
NY
01
—
7187629
AETNA
NY
Enumeration date
07/19/2006
Last updated
12/10/2024
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