Provider Demographics
NPI:1063803476
Name:HYON, KATHERINE SARAH SENGOBA (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SARAH SENGOBA
Last Name:HYON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:SARAH
Other - Last Name:SENGOBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1800 N MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3112
Mailing Address - Country:US
Mailing Address - Phone:630-653-4240
Mailing Address - Fax:630-315-6557
Practice Address - Street 1:1800 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3112
Practice Address - Country:US
Practice Address - Phone:630-653-4240
Practice Address - Fax:630-315-6557
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-08
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036152151207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology