Individual
JIM HONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 MAGNOLIA DR STE A, GLEN CARBON, IL 62034-1595
(618) 288-9466
Mailing address
104 MAGNOLIA DR STE A, GLEN CARBON, IL 62034-1595
(618) 288-9466
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036114185
IL
207Q00000X
Family Medicine Physician
Primary
036114185
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114185 - 4
—
IL
05
—
036114185001
—
IL
Enumeration date
08/04/2006
Last updated
02/01/2018
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