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Individual

DR. HARK CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 549-5361
(618) 549-5128

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036110494
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036110494
IL
01
088959
HAMP INSURANCE NUMBER
IL
01
196221
GHP INSURANCE NUMBER
IL
01
324123
GHP
IL
01
3932056
BCBS OF IL.
IL
01
630411
HEALTHLINK INSURANCE NUMB
IL
01
7210895
AETNA
IL
01
P00088940
RR MEDICARE NUMBER
IL
Enumeration date
08/16/2006
Last updated
05/03/2008
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