Hong, Jim

Hong, Jim is an individual health care provider with primary practice located at 104 Magnolia Dr Ste A , Glen Carbon IL 62034-1595. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Hong, Jim can be contacted via phone (618) 288-9466.

Contact Information

Primary practice address
104 Magnolia Dr Ste A Glen Carbon IL 62034-1595
Phone: (618) 288-9466
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036114185 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036114185 Illinois

Profile Details

NPI number 1487662656
LBN Legal business name Hong, Jim
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Feb 1st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487662656 NPPES
Illinois MEDICAID 036114185 - 4
Illinois MEDICAID 036114185001

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