Individual
DR. BENCHUAN GONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. (CHINA)
Contact information
Practice address
4921 N KIMBALL AVE, CHICAGO, IL 60625-5110
(773) 583-2142
Mailing address
4921 N KIMBALL AVE, CHICAGO, IL 60625-5110
(773) 583-2142
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198001152
IL
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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