Individual
EGEN ONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5140 W CHICAGO AVE, CHICAGO, IL 60651-2903
(773) 287-0751
Mailing address
6615 N KIMBALL AVE, LINCOLNWOOD, IL 60712-3731
(847) 983-4178
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036047126
IL
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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